Doctor Name: | DR. HARRY ARTHUR ROSELLE |
NPI Number: | 1992808042 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | MA21385 |
Business Practice Address: | 309 Engle St Ste #7 Englewood, NJ - 07631 |
Business Phone Number: | 2015672001 |
Business Fax Number: | 2015671929 |
Mailing Address: | 309 Engle St, Ste #7 ENGLEWOOD |
State: | NJ |
Postal Code: | 07631 |
Phone Number: | 2015672001 |
Fax Number: | 2015671929 |
NPI Enumeration Date: | 09/06/2006 |
NPI Last Update Date: | 11/15/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | MA21385 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |