Individual
DR. JOEL ROSENBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
114 WHITWELL ST, QUINCY MEDICAL CENTER, SUITE B618, QUINCY, MA 02169-1870
(617) 376-2095
(617) 376-5413
Mailing address
36 HALVORSEN AVE, HULL, MA 02045-2020
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
05087
MA
103T00000X
Psychologist
Primary
05087
MA
103TB0200X
Cognitive & Behavioral Psychologist
05087
MA
103TC0700X
Clinical Psychologist
05087
MA
103TR0400X
Rehabilitation Psychologist
05087
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0526894
—
MA
01
—
403324
TUFTS PROVIDER ID
MA
01
—
W05943
BLUE CROSS/BLUE SHIELD ID
MA
Enumeration date
06/27/2006
Last updated
09/11/2025
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