Doctor Name: | MR. LEE S. ROTTENBERG |
NPI Number: | 1033135090 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.A., CRC, LMHC |
License Number: | 002091 |
Business Practice Address: | 60-27 77 Street Middle Village, NY - 113795248 |
Business Phone Number: | 7184467257 |
Business Fax Number: | |
Mailing Address: | 60-27 77 Street, MIDDLE VILLAGE |
State: | NY |
Postal Code: | 113795248 |
Phone Number: | 7184467257 |
Fax Number: | |
NPI Enumeration Date: | 07/14/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 002091 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |