Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TA0700X | Adult Development & Aging Psychologist | 487S | MA |
NPI | 1649366253 |
---|---|
Provider Name | Dr. Erlene Rosowsky |
First Address | Needham, MA 02494 |
Second Address | Needham, MA 02494 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
751169 | TUFTS (01) | MA |
W04619 | (02) |