Basic Information
| Provider Information | |||||||||
| NPI: | 1336272053 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROSIEN | ||||||||
| FirstName: | IGOR | ||||||||
| MiddleName: | WLADIMIR | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 36 GILEAD HILL RD | ||||||||
| Address2: | |||||||||
| City: | NORTH CHILI | ||||||||
| State: | NY | ||||||||
| PostalCode: | 145141238 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5855942621 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 156 WEST AVE | ||||||||
| Address2: | |||||||||
| City: | BROCKPORT | ||||||||
| State: | NY | ||||||||
| PostalCode: | 144201229 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5853956095 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/13/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 209198 | NY | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.