Provider Demographics
NPI:1891326849
Name:ROSARIO, CARMEN M (MED)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:M
Last Name:ROSARIO
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 JEROME ST APT 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11207-2216
Mailing Address - Country:US
Mailing Address - Phone:347-593-3232
Mailing Address - Fax:
Practice Address - Street 1:8974 162ND ST STE 4
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-5012
Practice Address - Country:US
Practice Address - Phone:718-526-2400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-29
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker