Provider Demographics
NPI:1821680836
Name:ILANA D. ROSENBERG, PH.D., PSYCHOLOGY P.L.L.C.
Entity Type:Organization
Organization Name:ILANA D. ROSENBERG, PH.D., PSYCHOLOGY P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ILANA
Authorized Official - Middle Name:DEBRA
Authorized Official - Last Name:ROSENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:917-620-8749
Mailing Address - Street 1:50 POPHAM RD
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-4253
Mailing Address - Country:US
Mailing Address - Phone:917-620-8749
Mailing Address - Fax:
Practice Address - Street 1:50 POPHAM RD
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-4253
Practice Address - Country:US
Practice Address - Phone:917-620-8749
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty