Healthcare Provider Details

I. General information

NPI: 1790953883
Provider Name (Legal Business Name): NANCY ELPERIN ROSEN SOCIAL WORKER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2008
Last Update Date: 02/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8016 SNOW AVE NE
ALBUQUERQUE NM
87110-7618
US

IV. Provider business mailing address

8016 SNOW AVE NE
ALBUQUERQUE NM
87110-7618
US

V. Phone/Fax

Practice location:
  • Phone: 505-292-9894
  • Fax:
Mailing address:
  • Phone: 505-292-9894
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI-06025
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: