Provider Demographics
NPI:1588101745
Name:FOREFRONT-ROSENZWEIG MEDICAL SERVICES PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:FOREFRONT-ROSENZWEIG MEDICAL SERVICES PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:S
Authorized Official - Last Name:ROSENZWEIG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-369-6515
Mailing Address - Street 1:1717 MAIN ST STE 5850
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-7317
Mailing Address - Country:US
Mailing Address - Phone:866-959-2008
Mailing Address - Fax:888-972-2903
Practice Address - Street 1:17 ADELPHI AVE
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-4119
Practice Address - Country:US
Practice Address - Phone:401-369-6515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-26
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI7057693Medicaid
RI007059409Medicare PIN
RI7057693Medicaid