MEDICARE: BARBARA LYNNE ROSEN LCSW

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	070288	NY

General Provider Information

NPI Number	:	1417194309
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA LYNNE ROSEN LCSW

Provider Business Mailing Address
First Line	:	8020 45TH AVE
Second Line	:
City	:	ELMHURST
State	:	NY
Zip	:	11373-3545
Country	:	US
Telephone Number	:	718-478-2900
Fax Number	:	718-478-3456

Provider Business Practice Location Address
First Line	:	14109 72ND AVE
Second Line	:
City	:	KEW GARDENS HILLS
State	:	NY
Zip	:	11367-2331
Country	:	US
Telephone Number	:	718-544-0453
Fax Number	:

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

Provider Enumeration Date	:	01/14/2009
Last Update Date	:	01/14/2009

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