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General NPI Number Information
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NPI Number | 1407773245
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Entity Type | Individual
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Provider Name | YEHUDA ROSEN PHD
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Gender | Male
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Dates
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Enumeration Date | 07/02/2026
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Last Update Date | 07/02/2026
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Provider Practice Location Address
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Address Line | 635 DUQUESNE BLVD STE 2
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City | BRICK
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State | NJ
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Zip | 08723-5073
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Country | US
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Telephone | 201-566-3965
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Fax |
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Provider Business Mailing Address
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Address Line | 14733 70TH AVE
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City | FLUSHING
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State | NY
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Zip | 11367-1715
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Country | US
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Telephone | 201-566-3965
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 263-003
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License Number State | NJ
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