Basic Information
Provider Information
NPI: 1639177223
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ROSENFELD
FirstName: EDWARD
MiddleName: J
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1605 N CEDAR CREST BLVD STE 110B
Address2:  
City: ALLENTOWN
State: PA
PostalCode: 181042351
CountryCode: US
TelephoneNumber: 6109731410
FaxNumber: 6109731442
Practice Location
Address1: 1605 N CEDAR CREST BLVD STE 110B
Address2:  
City: ALLENTOWN
State: PA
PostalCode: 181042351
CountryCode: US
TelephoneNumber: 6109731410
FaxNumber: 6109731442
Other Information
ProviderEnumerationDate: 07/08/2005
LastUpdateDate: 12/14/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/14/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XMD043028EPAY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


Home