Provider Demographics
NPI:1649872995
Name:ROSSEN, BARBRA
Entity type:Individual
Prefix:
First Name:BARBRA
Middle Name:
Last Name:ROSSEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BROCHI
Other - Middle Name:
Other - Last Name:SCHIFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:919 MAYFIELD RD
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-1605
Mailing Address - Country:US
Mailing Address - Phone:347-563-3838
Mailing Address - Fax:
Practice Address - Street 1:919 MAYFIELD RD
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-1605
Practice Address - Country:US
Practice Address - Phone:347-563-3838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-11
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009898101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health