Individual
LUCY ROSENBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
75 JOHN ROBERTS RD BLDG B, SOUTH PORTLAND, ME 04106-6967
(207) 775-4151
Mailing address
75 JOHN ROBERTS RD BLDG B, SOUTH PORTLAND, ME 04106-6967
(207) 775-4151
(317) 777-6644
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD28267
ME
208000000X
Pediatrics Physician
MD28267
ME
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
MD28267
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300049958
—
IN
Enumeration date
03/30/2016
Last updated
07/25/2024
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