Individual
BRUCE ROSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
222 MIDDLE COUNTRY RD, SUITE 210, SMITHTOWN, NY 11787-2814
(631) 265-6868
(631) 265-6890
Mailing address
222 MIDDLE COUNTRY RD, SUITE 210, SMITHTOWN, NY 11787-2814
(631) 265-6868
(631) 265-6890
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
112715
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00204173
—
NY
Enumeration date
11/15/2006
Last updated
04/16/2008
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