Active NPI
Rose Vital, LMSW
- Social Worker
- Forest Hills, NY
National Provider Identifier
1346620754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 72 082335
- Practice address
- 70-00 Austin St, Suite 200
Forest Hills, NY 11375 - Phone
- (718) 762-7633
- NPI assigned
- Jun 2, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 72 082335 | NY | Primary |
Addresses
Primary practice location
70-00 Austin St, Suite 200
Forest Hills, NY 11375
Mailing address
10932 217 Street
Queens Village, NY 11429
Phone (516) 304-6772
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 72 082335 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433203200000",
"number": "1346620754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10932 217 STREET",
"city": "QUEENS VILLAGE",
"state": "NY",
"postal_code": "11429",
"telephone_number": "516-304-6772"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "70-00 AUSTIN ST, SUITE 200",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "11375",
"telephone_number": "718-762-7633"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VITAL",
"first_name": "ROSE",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-06-02",
"last_updated": "2015-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "72 082335",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forest Hills, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.