Healthcare Provider Details

I. General information

NPI: 1891880092
Provider Name (Legal Business Name): JODI ROSEN LCSWR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 07/02/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 E 68TH ST APT 2C
NEW YORK NY
10065-5719
US

IV. Provider business mailing address

215 E 68TH ST APT 2C
NEW YORK NY
10065-5719
US

V. Phone/Fax

Practice location:
  • Phone: 718-830-0246
  • Fax: 718-830-9088
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number0534731
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: