Individual
MR. ELIOT JAY ROSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW, DCSW, QCSW
Contact information
Practice address
13-3564 MOKU ST, PAHOA, HI 96778
(808) 965-1279
Mailing address
13-3564 MOKU ST, PAHOA, HI 96778
(808) 965-1279
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3097
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
52927401
—
HI
Enumeration date
10/04/2006
Last updated
07/09/2007
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