Individual
ALICIA SUZANNE ROSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5501 OLD YORK RD, PHILADELPHIA, PA 19141-3018
(215) 456-7890
Mailing address
2455 TULIP ST, PHILADELPHIA, PA 19125-2140
(267) 455-0120
Taxonomy
Speciality
Code
Description
License number
State
207ND0900X
Dermatopathology Physician
Primary
MD474494
PA
207R00000X
Internal Medicine Physician
MD474494
PA
390200000X
Student in an Organized Health Care Education/Training Program
MT215366
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1144710021
NPI
PA
Enumeration date
05/16/2018
Last updated
03/28/2022
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