Provider Demographics
NPI:1427049436
Name:ROSENBAUM, BARRY N (MD)
Entity type:Individual
Prefix:MR
First Name:BARRY
Middle Name:N
Last Name:ROSENBAUM
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 1:2ND FLOOR
Mailing Address - Street 2:3720 FARRAGUT AVENUE
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-2110
Mailing Address - Country:US
Mailing Address - Phone:301-949-4242
Mailing Address - Fax:301-949-8041
Practice Address - Street 1:2ND FLOOR
Practice Address - Street 2:3720 FARRAGUT AVENUE
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-2110
Practice Address - Country:US
Practice Address - Phone:301-949-4242
Practice Address - Fax:301-949-8041
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0009834207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCC066-0001OtherBCBS NCA
D09349Medicare UPIN
DC114419A88Medicare PIN