Provider Demographics
NPI:1649366253
Name:ROSOWSKY, ERLENE (PSYD)
Entity type:Individual
Prefix:DR
First Name:ERLENE
Middle Name:
Last Name:ROSOWSKY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 GREAT PLAIN AVENUE
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02494
Mailing Address - Country:US
Mailing Address - Phone:781-449-4215
Mailing Address - Fax:781-449-3134
Practice Address - Street 1:1040 GREAT PLAIN AVENUE
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02494
Practice Address - Country:US
Practice Address - Phone:781-449-4215
Practice Address - Fax:781-449-3134
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA487S103TA0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA751169OtherTUFTS
W04619Medicare UPIN
MAW04619Medicare ID - Type Unspecified