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General NPI Number Information
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NPI Number | 1730136177
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Entity Type | Individual
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Provider Name | AMY ROSEN PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 05/30/2006
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Last Update Date | 04/26/2017
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Provider Practice Location Address
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Address Line | 64 COUNTY ROAD 39
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City | SOUTHAMPTON
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State | NY
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Zip | 11968-5215
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Country | US
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Telephone | 631-702-1000
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Fax | 631-702-1010
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Provider Business Mailing Address
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Address Line | 31 NW LANDING RD
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City | EAST HAMPTON
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State | NY
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Zip | 11937-5122
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Country | US
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Telephone | 631-708-6040
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 013842-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 013842-1
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License Number State | NY
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