Provider Demographics
NPI:1407208127
Name:ROSA, NAHUEL (MSW)
Entity Type:Individual
Prefix:
First Name:NAHUEL
Middle Name:
Last Name:ROSA
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3044 29TH ST
Mailing Address - Street 2:2 G
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11102-2533
Mailing Address - Country:US
Mailing Address - Phone:347-291-7383
Mailing Address - Fax:
Practice Address - Street 1:3044 29TH ST
Practice Address - Street 2:2 G
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102-2533
Practice Address - Country:US
Practice Address - Phone:347-291-7383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-06
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical