Individual
KENNETH C ROSENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1015 CHESTNUT ST STE 512, PHILADELPHIA, PA 19107-4305
(267) 479-4180
(215) 873-0201
Mailing address
207 N BROAD ST FL 3, PHILADELPHIA, PA 19107-1500
(267) 479-4180
(215) 873-0201
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MD023084E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009081150005
—
PA
01
—
0055166000
IBC
PA
01
—
0431147
HIGHMARK BLUE SHIELD
PA
Enumeration date
08/30/2006
Last updated
07/14/2023
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