Provider Demographics
NPI:1164691804
Name:ROSENBAUM, MARCOS
Entity Type:Individual
Prefix:MR
First Name:MARCOS
Middle Name:
Last Name:ROSENBAUM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 COLUMBIA ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-2432
Mailing Address - Country:US
Mailing Address - Phone:508-620-2476
Mailing Address - Fax:508-620-2637
Practice Address - Street 1:300 HOWARD ST
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-8313
Practice Address - Country:US
Practice Address - Phone:508-879-2250
Practice Address - Fax:508-620-2637
Is Sole Proprietor?:No
Enumeration Date:2008-02-27
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker