Provider Demographics
NPI:1750366407
Name:ROSEN, HAROLD (MD)
Entity type:Individual
Prefix:
First Name:HAROLD
Middle Name:
Last Name:ROSEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 30170
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-7170
Mailing Address - Country:US
Mailing Address - Phone:302-623-7362
Mailing Address - Fax:302-623-7374
Practice Address - Street 1:501 W 14TH ST
Practice Address - Street 2:WILMINGTON HOSPITAL
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-1013
Practice Address - Country:US
Practice Address - Phone:302-428-2962
Practice Address - Fax:302-428-4934
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DEC100042572084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEC30118Medicare UPIN
DE408565C60Medicare PIN