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Individual

DR. RANDY ROSENBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3509 N BROAD ST, PHILADELPHIA, PA 19140-4105
(215) 707-3040
(215) 707-8235
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-3040

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
MD016929E
PA
2084N0400X
Neurology Physician
Primary
MD016929E
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01108143
PA
Enumeration date
06/01/2006
Last updated
02/05/2015
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