Doctor Name: | DR. JANINE WEISS ROSE |
NPI Number: | 1144461534 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | 8038-1 |
Business Practice Address: | 132 Harbor Ln Massapequa Park, NY - 117624003 |
Business Phone Number: | 5167991820 |
Business Fax Number: | 5167991820 |
Mailing Address: | 132 Harbor Ln, MASSAPEQUA PARK |
State: | NY |
Postal Code: | 117624003 |
Phone Number: | 5167991820 |
Fax Number: | 5167991820 |
NPI Enumeration Date: | 03/13/2009 |
NPI Last Update Date: | 03/13/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 8038-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |