Provider Demographics
NPI:1003295494
Name:ROSEN, HEATHER RACHEL (PHD)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:RACHEL
Last Name:ROSEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:HEATHER
Other - Middle Name:RACHEL
Other - Last Name:MOSHIRI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:400 KING ST STE 7
Mailing Address - Street 2:
Mailing Address - City:CHAPPAQUA
Mailing Address - State:NY
Mailing Address - Zip Code:10514-3500
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:400 KING ST STE 7
Practice Address - Street 2:
Practice Address - City:CHAPPAQUA
Practice Address - State:NY
Practice Address - Zip Code:10514-3500
Practice Address - Country:US
Practice Address - Phone:347-560-4628
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-19
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30234103T00000X
NY025653103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist