Healthcare Provider Details

I. General information

NPI: 1568124527
Provider Name (Legal Business Name): ROSLYN A GUZMAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2021
Last Update Date: 01/16/2023
Certification Date: 01/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 NORTH AVE
NEW ROCHELLE NY
10801-6450
US

IV. Provider business mailing address

255 NORTH AVE # 1068
NEW ROCHELLE NY
10801-6450
US

V. Phone/Fax

Practice location:
  • Phone: 718-536-1150
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number093648
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number093277
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: