Provider Demographics
NPI:1154384808
Name:ROSIN, NORMAN L (MD)
Entity type:Individual
Prefix:
First Name:NORMAN
Middle Name:L
Last Name:ROSIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 ALETHA RD
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02492-4302
Mailing Address - Country:US
Mailing Address - Phone:781-444-2307
Mailing Address - Fax:781-449-5361
Practice Address - Street 1:111 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02492-2900
Practice Address - Country:US
Practice Address - Phone:781-444-7186
Practice Address - Fax:781-449-5361
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA30762174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3030920Medicaid
MA058989OtherTUFT HEALTH PLAN
MA20442OtherHPHC
MA1201383OtherUNITED HEALTH PLAN
MAM07361OtherBCBS
MA2802231OtherAETNA
MAB10240501OtherCIGNA
MA3030920Medicaid