Individual provider Active NPI

Janine Weiss Rose, PH.D.

  • Clinical Psychologist
  • Massapequa Park, NY
National Provider Identifier
1144461534
Registry record updated Mar 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
8038-1 Issued in NY
Practice address
132 Harbor LN
Massapequa Park, NY 11762-4003
Phone
(516) 799-1820
Fax
(516) 799-1820
NPI assigned
Mar 13, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 8038-1 NY Primary

Addresses

Primary practice location

132 Harbor LN
Massapequa Park, NY 11762-4003

Mailing address

132 Harbor LN
Massapequa Park, NY 11762-4003
Phone (516) 799-1820

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
8038-1NYMDClinical Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1236902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236902400000",
    "number": "1144461534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 HARBOR LN",
            "city": "MASSAPEQUA PARK",
            "state": "NY",
            "postal_code": "117624003",
            "telephone_number": "516-799-1820",
            "fax_number": "516-799-1820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 HARBOR LN",
            "city": "MASSAPEQUA PARK",
            "state": "NY",
            "postal_code": "117624003",
            "telephone_number": "516-799-1820",
            "fax_number": "516-799-1820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "JANINE",
        "middle_name": "WEISS",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-13",
        "last_updated": "2009-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "8038-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Massapequa Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.