Provider Demographics
NPI:1649254673
Name:ROSENBERG, DARREN C (DO)
Entity type:Individual
Prefix:DR
First Name:DARREN
Middle Name:C
Last Name:ROSENBERG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:508-872-2200
Mailing Address - Fax:508-872-1205
Practice Address - Street 1:570 WORCESTER ROAD
Practice Address - Street 2:SPAULDING NEIGHBORHOOD REHAB CENTER
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701
Practice Address - Country:US
Practice Address - Phone:508-872-2200
Practice Address - Fax:508-872-1205
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2012-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA160141208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3193829Medicaid
MA160141OtherTUFTS HEALTH PLAN
MAJ21132OtherBCBS MA
MAA29814Medicare ID - Type Unspecified
MA3193829Medicaid