MEDICARE: ROSITANO CONSULTING LLC

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1750985529
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROSITANO CONSULTING LLC

Provider Business Mailing Address
First Line	:	1443 E 57TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-4003
Country	:	US
Telephone Number	:	347-713-2604
Fax Number	:

Provider Business Practice Location Address
First Line	:	1443 E 57TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-4003
Country	:	US
Telephone Number	:	347-713-2604
Fax Number	:

Authorized Official
Title or Position	:	MENTAL HEALTH THERAPIST
Name	:	MS. THERESA ANN ROSITANO
Credential	:	LCSW
Telephone Number	:	347-713-2604

Provider Enumeration Date	:	11/23/2020
Last Update Date	:	11/24/2020

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