Provider Demographics
NPI:1417212275
Name:DAMATO, ROSE (MS)
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:
Last Name:DAMATO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:ROSE
Other - Middle Name:
Other - Last Name:BARTOLOTTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:125 E BETHPAGE RD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-4228
Mailing Address - Country:US
Mailing Address - Phone:516-731-5588
Mailing Address - Fax:
Practice Address - Street 1:125 E BETHPAGE RD
Practice Address - Street 2:SUITE 5
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-4228
Practice Address - Country:US
Practice Address - Phone:516-731-5588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-09
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool