Dave Rosenbaum, PH. D
Individual provider Active NPI Psychologist · Muttontown, NY
NPI 1669523486 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1669523486
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- 4825 (NY)
- Practice address
- 1906 Muttontown Road
Muttontown, NY 11791 - Phone
- (516) 496-9520
- Fax
- (516) 496-9523
- NPI assigned
- Jan 16, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4825 | NY | MD | Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 4825 | NY | Yes |
Addresses
Primary practice location
1906 Muttontown Road
Muttontown, NY 11791
Mailing address
1906 Muttontown Road
Muttontown, NY 11791
Phone (516) 496-9520
Other providers in Muttontown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.