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NPI Code Detail

MEDICARE: MRS. ILANA H. ROSEN LCSW-R

MEDICARE: MRS. ILANA H. ROSEN LCSW-R
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 WorkerR-075910NY

General Provider Information

NPI Number : 1841563871
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ILANA H. ROSEN LCSW-R
Provider Business Mailing Address
First Line : 3 MARCIA LANE
Second Line :
City : SPRING VALLEY
State : NY
Zip : 10977-2018
Country : US
Telephone Number : 845-499-0725
Fax Number : 845-371-6381
Provider Business Practice Location Address
First Line : 3 MARCIA LANE
Second Line :
City : SPRING VALLEY
State : NY
Zip : 10977-2018
Country : US
Telephone Number : 845-499-0725
Fax Number : 845-371-6381
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2012
Last Update Date : 02/22/2012

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