Provider Demographics
NPI:1811080450
Name:ROSEN, BARBARA L (AUD)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:L
Last Name:ROSEN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 NORTH VILLAGE AVENUE
Mailing Address - Street 2:SUITE 119
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570
Mailing Address - Country:US
Mailing Address - Phone:516-764-2094
Mailing Address - Fax:
Practice Address - Street 1:165 NORTH VILLAGE AVENUE
Practice Address - Street 2:SUITE 119
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570
Practice Address - Country:US
Practice Address - Phone:516-764-2094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000046-1231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYM01001Medicare ID - Type Unspecified
NYM01001Medicare UPIN