Individual
BRYAN RUSSELL ROTHENSTEIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
22005 JAMAICA AVE, QUEENS VILLAGE, NY 11428-2140
(718) 740-5000
(718) 479-0200
Mailing address
6127 224TH ST, APT A, OAKLAND GARDENS, NY 11364-2331
(917) 608-5763
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
084913
NY
Other
Enumeration date
02/16/2012
Last updated
02/16/2012
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