Healthcare Provider Details

I. General information

NPI: 1801483748
Provider Name (Legal Business Name): FRANCISCO ROSARIO-ORTIZ, PHD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2020
Last Update Date: 12/27/2020
Certification Date: 12/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 BLAKE ST APT 3402
NEW HAVEN CT
06515-4415
US

IV. Provider business mailing address

400 BLAKE ST APT 3402
NEW HAVEN CT
06515-4415
US

V. Phone/Fax

Practice location:
  • Phone: 787-579-4126
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. FRANCISCO JAVIER ROSARIO
Title or Position: CLINICAL PSYCHOLOGIST
Credential: PHD
Phone: 787-579-4126