Individual
MR. IRA J ROSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH D
Contact information
Practice address
443 MAIN ST, LEWISTON, ME 04240-6733
(207) 786-0270
(207) 783-0500
Mailing address
443 MAIN ST, LEWISTON, ME 04240-6733
(207) 786-0270
(207) 783-0500
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS206
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003382
ANTHEM BCBS
ME
Enumeration date
09/26/2006
Last updated
07/08/2007
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