Provider Demographics
NPI:1245355031
Name:ROSNICK, LYLE EUGENE (MD)
Entity type:Individual
Prefix:DR
First Name:LYLE
Middle Name:EUGENE
Last Name:ROSNICK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:129 E 82ND STREET
Mailing Address - Street 2:APT 3C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028
Mailing Address - Country:US
Mailing Address - Phone:212-628-7670
Mailing Address - Fax:212-249-0763
Practice Address - Street 1:10 E 85TH STREET
Practice Address - Street 2:SUITE 1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-0412
Practice Address - Country:US
Practice Address - Phone:212-369-4978
Practice Address - Fax:212-249-0763
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY124758103TP0814X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
322661LRMedicare UPIN