Provider Demographics
NPI:1750675930
Name:PAUL, JONATHAN ROSKIN (LMSW)
Entity Type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:ROSKIN
Last Name:PAUL
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 E 86TH ST
Mailing Address - Street 2:15 C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-0510
Mailing Address - Country:US
Mailing Address - Phone:917-992-8942
Mailing Address - Fax:
Practice Address - Street 1:7 E 86TH ST
Practice Address - Street 2:15 C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-0510
Practice Address - Country:US
Practice Address - Phone:917-992-8942
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-05
Last Update Date:2011-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0833411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical