Provider Demographics
NPI:1174517817
Name:ROSENSTEIN, RICHARD P (DO)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:P
Last Name:ROSENSTEIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:374 MOUNTAIN BLVD
Mailing Address - Street 2:
Mailing Address - City:WERNERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19565-9219
Mailing Address - Country:US
Mailing Address - Phone:585-233-2817
Mailing Address - Fax:570-300-1829
Practice Address - Street 1:374 MOUNTAIN BLVD
Practice Address - Street 2:
Practice Address - City:WERNERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19565-9219
Practice Address - Country:US
Practice Address - Phone:585-233-2817
Practice Address - Fax:570-300-1829
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS008839L208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1866304OtherAETNA HMO
PA5961641OtherAETNA PPO
0731708000OtherKHPE
PA5961641OtherAETNA PPO