Provider Demographics
NPI:1871863746
Name:ROSENBERG, BARRY PHILIP (MS ED)
Entity Type:Individual
Prefix:MR
First Name:BARRY
Middle Name:PHILIP
Last Name:ROSENBERG
Suffix:
Gender:M
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 1:3914 15TH AVENUE
Mailing Address - Street 2:JUMPSTART EARLY INTERVENTION PROGRAM
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3914 15TH AVENUE
Practice Address - Street 2:JUMPSTART EARLY INTERVENTION PROGRAM
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218
Practice Address - Country:US
Practice Address - Phone:718-984-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-09
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYCONTROL#043084841101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health