Provider Demographics
NPI:1285971150
Name:ROSEMAN, EMILY (PHD)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:
Last Name:ROSEMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:179 BELLEMEADE RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-3528
Mailing Address - Country:US
Mailing Address - Phone:631-444-8053
Mailing Address - Fax:
Practice Address - Street 1:179 N BELLE MEAD RD
Practice Address - Street 2:SUITE 3
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-3528
Practice Address - Country:US
Practice Address - Phone:631-444-8053
Practice Address - Fax:631-444-1975
Is Sole Proprietor?:No
Enumeration Date:2013-01-11
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY68019622103G00000X, 103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical