Provider Demographics
NPI:1457562589
Name:SIDNEY ROSEN M.D. P.C.
Entity type:Organization
Organization Name:SIDNEY ROSEN M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SIDNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-517-9272
Mailing Address - Street 1:122 E 82ND ST
Mailing Address - Street 2:1-B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-0822
Mailing Address - Country:US
Mailing Address - Phone:212-517-9272
Mailing Address - Fax:212-722-7594
Practice Address - Street 1:122 E 82ND ST
Practice Address - Street 2:1-B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-0822
Practice Address - Country:US
Practice Address - Phone:212-517-9272
Practice Address - Fax:212-722-7594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY072594261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health