Individual
DR. DEAN ALAN ROSENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
217 6TH ST, RACINE, WI 53403-1213
(262) 634-4430
(262) 634-1890
Mailing address
217 6TH ST, RACINE, WI 53403-1213
(262) 634-4430
(262) 634-1890
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2220TPA
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38574400
—
WI
01
—
391951110
OLD MEDICARE PIN
WI
01
—
P00435918
RAILROAD MEDICARE PART B
WI
Enumeration date
12/07/2005
Last updated
06/11/2020
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