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DR. JOEL ROSENBAUM PH.D.

Clinical Neuropsychologist

Quincy, Massachusetts

Provider NPI: 1821025800

Provider Information:
DR. JOEL  ROSENBAUM PH.D.
Gender: M
Sole Proprietor


Practice Location:
114 WHITWELL ST QUINCY MEDICAL CENTER, SUITE B618 QUINCY, MA 02169 US
Tel: 617-376-2095  Fax: 617-376-5413

Business Mailing Address:
36 HALVORSEN AVE  HULL, MA 02045 US
Tel: --  Fax: --

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
X103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
MA05087
X103T00000XBehavioral Health & Social Service Providers
Psychologist
MA05087
X103TB0200XBehavioral Health & Social Service Providers
Psychologist
MA05087
X103TC0700XBehavioral Health & Social Service Providers
Psychologist
MA05087
X103TR0400XBehavioral Health & Social Service Providers
Psychologist
MA05087

Other Provider Identifiers:

IssuerNumberStateType
BLUE CROSS/BLUE SHIELD IDW05943MA01
0526894MA05
TUFTS PROVIDER ID403324MA01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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