Individual
JASON ROSENFELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
25 AVENUE D, NEW YORK, NY 10009-6935
(718) 840-0699
Mailing address
25 AVENUE D, NEW YORK, NY 10009-6935
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
—
NY
175T00000X
Peer Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MK61641A
—
NY
Enumeration date
12/16/2018
Last updated
12/16/2018
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