Individual
DR. BRUCE ROBERT ROSEN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD PHD
Contact information
Practice address
149 13TH ST, 149 2301 MGH IMAGING CENTER, CHARLESTOWN, MA 02129
(617) 726-5122
(617) 726-7422
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
57775
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
057775
TUFTS HEALTH PLAN
MA
05
—
3020126
—
MA
01
—
J06262
BCBS MA
MA
Enumeration date
02/14/2006
Last updated
07/08/2007
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