MEDICARE: BRIDGET ROONEY MS.ED

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	252Y00000X	Early Intervention Provider Agency	3955633	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588390223
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIDGET ROONEY MS.ED

Provider Business Mailing Address
First Line	:	2235 FREDERICK DOUGLASS BLVD APT 2D
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10027-6129
Country	:	US
Telephone Number	:	718-730-0792
Fax Number	:

Provider Business Practice Location Address
First Line	:	2235 FREDERICK DOUGLASS BLVD APT 2D
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10027-6129
Country	:	US
Telephone Number	:	718-730-0792
Fax Number	:

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

Provider Enumeration Date	:	07/26/2022
Last Update Date	:	07/26/2022

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Directions to “ BRIDGET ROONEY MS.ED” Practice Location

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