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NPI Code Detail

MEDICARE: HANNAH GRACE ROSENBLATT LCSW

MEDICARE:   HANNAH GRACE ROSENBLATT  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
11041C0700XClinical Social Worker10773CT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1508417056
Entity Type Code : Individual
Provider Name (Legal Business Name) : HANNAH GRACE ROSENBLATT LCSW
Provider Business Mailing Address
First Line : 400 COLUMBUS AVENUE
Second Line : CREDENTIALING SPECIALIST
City : NEW HAVEN
State : CT
Zip : 06519-1233
Country : US
Telephone Number : 203-503-3000
Fax Number : 203-503-3183
Provider Business Practice Location Address
First Line : 226 DIXWELL AVENUE
Second Line : NORTHSIDE
City : NEW HAVEN
State : CT
Zip : 06511-0651
Country : US
Telephone Number : 203-503-3470
Fax Number : 203-503-3478
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2019
Last Update Date : 09/26/2019

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