Provider Demographics
NPI:1699941708
Name:ROTHENBERG, ANDREA (LCSW)
Entity type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:
Last Name:ROTHENBERG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 LINWOOD AVE
Mailing Address - Street 2:APT. 14T
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-3086
Mailing Address - Country:US
Mailing Address - Phone:646-334-0174
Mailing Address - Fax:212-427-7523
Practice Address - Street 1:MOUNT SINAI HOSPITAL
Practice Address - Street 2:1 GUSTAVE LEVY PLACE BOX 1502
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029
Practice Address - Country:US
Practice Address - Phone:646-334-0174
Practice Address - Fax:212-427-7523
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical