Provider Demographics
NPI:1407163025
Name:YENEIC ROSEN, SABRINA ANN (MS ED)
Entity Type:Individual
Prefix:MRS
First Name:SABRINA
Middle Name:ANN
Last Name:YENEIC ROSEN
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:192 VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-1731
Mailing Address - Country:US
Mailing Address - Phone:718-285-4587
Mailing Address - Fax:
Practice Address - Street 1:192 VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-1731
Practice Address - Country:US
Practice Address - Phone:718-285-4587
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-02
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003459101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health