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General NPI Number Information
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NPI Number | 1770778110
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Entity Type | Individual
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Provider Name | ILANA SCHLEIN ROSENBERG PHD
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Gender | Female
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Dates
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Enumeration Date | 09/10/2007
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Last Update Date | 09/10/2007
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Provider Practice Location Address
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Address Line | 1 PROSPECT ST
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City | RIDGEWOOD
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State | NJ
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Zip | 07450-4404
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Country | US
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Telephone | 201-921-3560
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Fax | 201-236-8855
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Provider Business Mailing Address
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Address Line | 1 OAK RD
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City | SADDLE RIVER
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State | NJ
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Zip | 07458-3011
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Country | US
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Telephone | 201-921-3560
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Fax | 201-236-8855
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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 | 4447
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License Number State | NJ
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