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General NPI Number Information
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NPI Number | 1790997062
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Entity Type | Individual
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Provider Name | IRIS A ROSEN LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 299 PACIFIC ST
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City | BROOKLYN
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State | NY
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Zip | 11201-6317
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Country | US
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Telephone | 212-938-4040
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Fax | 212-938-4037
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Provider Business Mailing Address
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Address Line | 759 PRESIDENT ST APT 2C
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City | BROOKLYN
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State | NY
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Zip | 11215-1360
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Country | US
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Telephone | 212-938-4040
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Fax | 212-938-4037
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | R044839
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License Number State | NY
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