Provider Demographics
NPI:1114641388
Name:ROSEBERG WATSTEIN, TEMA (PHD)
Entity Type:Individual
Prefix:
First Name:TEMA
Middle Name:
Last Name:ROSEBERG WATSTEIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:TEMA
Other - Middle Name:
Other - Last Name:WATSTEIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:175 W 13TH ST APT 1B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-7803
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:500 SAINT JOHNS PL
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-5452
Practice Address - Country:US
Practice Address - Phone:203-804-1782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-30
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist