Provider Demographics
NPI:1811938921
Name:ROSENFELD, PHILIP A (MD)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:A
Last Name:ROSENFELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:994 OLD EAGLE SCHOOL RD
Mailing Address - Street 2:SUITE 1017
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-1802
Mailing Address - Country:US
Mailing Address - Phone:610-902-6092
Mailing Address - Fax:610-902-6081
Practice Address - Street 1:1245 HIGHLAND AVE
Practice Address - Street 2:SUITE 502
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001-3714
Practice Address - Country:US
Practice Address - Phone:215-886-1482
Practice Address - Fax:215-886-1491
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD010212E207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006644300001Medicaid
PA018079Medicare ID - Type Unspecified
PA0006644300001Medicaid