MEDICARE: MRS. SANDRA ROSENGARTEN LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	R043043	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2226111	OTHER	NY	CIGNA
2	NB938	OTHER	NY	UBH,AETNA
3	7480995	OTHER	NY	GHI
4	NB938	OTHER	NY	EMPIRE/MAGELLAN
5	254994	OTHER	NY	MHN
6	P1099554	OTHER	NY	OXFORD

General Provider Information

NPI Number	:	1376527101
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SANDRA ROSENGARTEN LCSW

Provider Business Mailing Address
First Line	:	9 PINE DR
Second Line	:
City	:	PORT WASHINGTON
State	:	NY
Zip	:	11050-3403
Country	:	US
Telephone Number	:	516-883-0528
Fax Number	:	516-883-0528

Provider Business Practice Location Address
First Line	:	9 PINE DR
Second Line	:
City	:	PORT WASHINGTON
State	:	NY
Zip	:	11050-3403
Country	:	US
Telephone Number	:	516-883-0528
Fax Number	:	516-883-0528

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2005
Last Update Date	:	08/05/2010

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Directions to “ MRS. SANDRA ROSENGARTEN LCSW” Practice Location

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