Individual
JONATHAN ROSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
1760 2ND AVE APT 18A, NEW YORK, NY 10128-5392
(516) 581-2113
Mailing address
1760 2ND AVE APT 18A, NEW YORK, NY 10128-5392
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
023638
NY
103TS0200X
School Psychologist
Primary
023638
NY
Other
Enumeration date
10/07/2020
Last updated
10/07/2020
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