| Laurence Rosen Lcsw Llc | |
|
16 Mountainside Park Ter Upper Montclair NJ 07043-1209 | |
| (973) 783-8673 | |
| Not Available |
| Full Name | Laurence Rosen Lcsw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 16 Mountainside Park Ter, Upper Montclair, New Jersey |
| Authorized Official Name and Position | Laurence Roy Rosen (OWNER) |
| Authorized Official Contact | 9737838673 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Laurence Rosen Lcsw Llc 16 Mountainside Park Ter Upper Montclair NJ 07043-1209 Ph: (973) 783-8673 | Laurence Rosen Lcsw Llc 16 Mountainside Park Ter Upper Montclair NJ 07043-1209 Ph: (973) 783-8673 |
| NPI Number | 1538478219 |
|---|---|
| Provider Enumeration Date | 09/29/2010 |
| Last Update Date | 09/29/2010 |
| Medicare PECOS PAC ID | 5496934127 |
|---|---|
| Medicare Enrollment ID | O20110126000768 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538478219 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Laurence R Rosen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710044102 PECOS PAC ID: 6901843291 Enrollment ID: I20050408000138 |
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