Provider Demographics
NPI:1699764498
Name:ROZENGARTEN, MICHAEL J (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:ROZENGARTEN
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 1:104 PHEASANT RUN
Mailing Address - Street 2:SUITE 128
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-3439
Mailing Address - Country:US
Mailing Address - Phone:215-860-3344
Mailing Address - Fax:215-860-8950
Practice Address - Street 1:104 PHEASANT RUN STE 128
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-3428
Practice Address - Country:US
Practice Address - Phone:215-860-3344
Practice Address - Fax:215-860-3348
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07995700207RC0001X, 207RC0000X
PAMD427309207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA095250LWHMedicare PIN
I26165Medicare UPIN