Basic Information
| Provider Information | |||||||||
| NPI: | 1023076254 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROSEN | ||||||||
| FirstName: | CARLO | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 DEACONESS RD | ||||||||
| Address2: | WEST CC-2, EMERGENCY MEDICINE | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 022155321 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177542339 | ||||||||
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| Practice Location | |||||||||
| Address1: | ONE DEACONESS RD/WEST CC-2 | ||||||||
| Address2: | BETH ISRAEL DEACONESS MED CTR | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177542339 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2006 | ||||||||
| LastUpdateDate: | 09/06/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 81099 | MA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.