Provider Demographics
NPI:1427727353
Name:ROSEN, JESSICA BETH
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:BETH
Last Name:ROSEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 AMSTERDAM AVE FRNT B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-5751
Mailing Address - Country:US
Mailing Address - Phone:646-984-8925
Mailing Address - Fax:
Practice Address - Street 1:115 E 87TH ST APT 25D
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1171
Practice Address - Country:US
Practice Address - Phone:917-816-2001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-13
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker