Doctor Name: | MR. MARTIN ALAN ROSOLINSKY |
NPI Number: | 1699831495 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW |
License Number: | RP014646-1 |
Business Practice Address: | 982 Montauk Highway Bayport, NY - 11705 |
Business Phone Number: | 5169916031 |
Business Fax Number: | |
Mailing Address: | 15 Ash Dr, MEDFORD |
State: | NY |
Postal Code: | 117634301 |
Phone Number: | 6316549392 |
Fax Number: | |
NPI Enumeration Date: | 12/28/2006 |
NPI Last Update Date: | 11/06/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | RP014646-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |