Individual
AMY ROSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
64 COUNTY ROAD 39, SOUTHAMPTON, NY 11968-5215
(631) 702-1000
(631) 702-1010
Mailing address
31 NW LANDING RD, EAST HAMPTON, NY 11937-5122
(631) 708-6040
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
013842-1
NY
103TS0200X
School Psychologist
Primary
013842-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02694728
—
NY
Enumeration date
05/30/2006
Last updated
04/26/2017
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