Individual
DR. JERROLD N ROSENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
827 N MAIN ST, SUITE 6, PROVIDENCE, RI 02904-5751
(401) 453-5030
(401) 453-5033
Mailing address
827 N MAIN ST, SUITE 6, PROVIDENCE, RI 02904-5751
(401) 453-5030
(401) 453-5033
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MD07222
RI
208100000X
Physical Medicine & Rehabilitation Physician
MD7222
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1134
BCBSRI
RI
01
—
1570/4122
NHP
RI
01
—
200688
BLUE CHIP
RI
05
—
9001134
—
RI
Enumeration date
06/23/2005
Last updated
09/19/2013
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