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General NPI Number Information
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NPI Number | 1215389143
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Entity Type | Individual
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Provider Name | NICOLE M ROSEN M.A., SLP
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Gender | Female
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Dates
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Enumeration Date | 07/02/2016
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Last Update Date | 01/14/2026
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Provider Practice Location Address
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Address Line | 5 MERLE LN
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City | MASSAPEQUA PARK
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State | NY
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Zip | 11762-1945
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Country | US
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Telephone | 516-644-7425
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Fax |
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Provider Business Mailing Address
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Address Line | 74 ARLYN DR E
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City | MASSAPEQUA
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State | NY
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Zip | 11758-6107
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Country | US
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Telephone | 516-644-7425
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 025823
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License Number State | NY
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