Basic Information
| Provider Information | |||||||||
| NPI: | 1508020587 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROSEN | ||||||||
| FirstName: | SETH | ||||||||
| MiddleName: | I | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3198 GRAND CONCOURSE | ||||||||
| Address2: | |||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104581000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7186180401 | ||||||||
| FaxNumber: | 7187954394 | ||||||||
| Practice Location | |||||||||
| Address1: | 2025 BROADWAY | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100235016 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2123908812 | ||||||||
| FaxNumber: | 2123908814 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/18/2008 | ||||||||
| LastUpdateDate: | 04/10/2019 | ||||||||
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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 | 207R00000X | MD038962 | DC | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | D0071774 | MD | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 269660 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.