Provider Demographics
NPI:1902793854
Name:ROSARIO, CARLOS MANUEL
Entity type:Individual
Prefix:
First Name:CARLOS MANUEL
Middle Name:
Last Name:ROSARIO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1230 SUTTER AVE APT 6D
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11208-3821
Mailing Address - Country:US
Mailing Address - Phone:646-706-1246
Mailing Address - Fax:
Practice Address - Street 1:1230 SUTTER AVE APT 6D
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11208-3821
Practice Address - Country:US
Practice Address - Phone:646-706-1246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist