Provider Demographics
NPI:1124060595
Name:ST. BARNABAS OB GYN, PC
Entity type:Organization
Organization Name:ST. BARNABAS OB GYN, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF PC
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROSING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-960-9415
Mailing Address - Street 1:4422 THIRD AVENUE
Mailing Address - Street 2:ANNEX BLD
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-2545
Mailing Address - Country:US
Mailing Address - Phone:718-960-9415
Mailing Address - Fax:718-960-9414
Practice Address - Street 1:4422 THIRD AVENUE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-2545
Practice Address - Country:US
Practice Address - Phone:718-960-9415
Practice Address - Fax:718-960-9414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01928463Medicaid