MEDICARE: MR. DAVID ANTHONY ROSEN M.S.W.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	44SC04642400	NJ

General Provider Information

NPI Number	:	1013208529
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID ANTHONY ROSEN M.S.W.

Provider Business Mailing Address
First Line	:	1907 ROUTE 27
Second Line	:
City	:	EDISON
State	:	NJ
Zip	:	08817-3212
Country	:	US
Telephone Number	:	732-985-1211
Fax Number	:	732-985-3609

Provider Business Practice Location Address
First Line	:	1907 ROUTE 27
Second Line	:
City	:	EDISON
State	:	NJ
Zip	:	08817-3212
Country	:	US
Telephone Number	:	732-985-1211
Fax Number	:	732-985-3609

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/02/2011
Last Update Date	:	05/02/2011

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