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General NPI Number Information
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NPI Number | 1821025800
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Entity Type | Individual
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Provider Name | JOEL ROSENBAUM PH.D.
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Gender | Male
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Dates
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Enumeration Date | 06/27/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 114 WHITWELL ST QUINCY MEDICAL CENTER, SUITE B618
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City | QUINCY
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State | MA
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Zip | 02169-1870
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Country | US
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Telephone | 617-376-2095
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Fax | 617-376-5413
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Provider Business Mailing Address
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Address Line | 36 HALVORSEN AVE
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City | HULL
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State | MA
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Zip | 02045-2020
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Country | US
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Telephone |
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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 | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 05087
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | 05087
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 05087
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 05087
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License Number State | MA
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Taxonomy #5
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Taxonomy Code | 103TR0400X
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Taxonomy Name | Rehabilitation Psychologist
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License Number | 05087
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License Number State | MA
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