| Doctor Name: | MR. ELIOT JAY ROSEN |
| NPI Number: | 1689760241 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MSW, DCSW, QCSW |
| License Number: | 3097 |
| Business Practice Address: | 13-3564 Moku St Pahoa, HI - 96778 |
| Business Phone Number: | 8089651279 |
| Business Fax Number: | |
| Mailing Address: | 13-3564 Moku St, PAHOA |
| State: | HI |
| Postal Code: | 96778 |
| Phone Number: | 8089651279 |
| Fax Number: | |
| NPI Enumeration Date: | 10/04/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 3097 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | HI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |