Provider Demographics
NPI:1588772628
Name:ROSEN, AMY BETH (DC)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:BETH
Last Name:ROSEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:528 LORING AVE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970
Mailing Address - Country:US
Mailing Address - Phone:978-745-6868
Mailing Address - Fax:978-745-9898
Practice Address - Street 1:528 LORING AVE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970
Practice Address - Country:US
Practice Address - Phone:978-745-6868
Practice Address - Fax:978-745-9898
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2010111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
621514OtherTUFTS HEALTH
662419OtherUNITED HEALTH
AA9801OtherHARVARD PILGRIM
Y36837OtherBCBS
Y45478Medicare ID - Type Unspecified