Provider Demographics
NPI:1528249240
Name:ROBERT ROSENZWEIG M D P C
Entity type:Organization
Organization Name:ROBERT ROSENZWEIG M D P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:ROSENZWEIG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-483-1230
Mailing Address - Street 1:6565 SPRING BROOK AVE STE 8
Mailing Address - Street 2:
Mailing Address - City:RHINEBECK
Mailing Address - State:NY
Mailing Address - Zip Code:12572-3726
Mailing Address - Country:US
Mailing Address - Phone:845-876-3003
Mailing Address - Fax:845-483-1232
Practice Address - Street 1:6511 SPRING BROOK AVE
Practice Address - Street 2:
Practice Address - City:RHINEBECK
Practice Address - State:NY
Practice Address - Zip Code:12572-3709
Practice Address - Country:US
Practice Address - Phone:845-876-4432
Practice Address - Fax:845-876-9086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-21
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY172383207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01246762Medicaid
NY01246762Medicaid
NYWEH931Medicare PIN