Provider Demographics
NPI:1073833158
Name:ROZENBERG, ANNETA
Entity Type:Individual
Prefix:
First Name:ANNETA
Middle Name:
Last Name:ROZENBERG
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 1:2469 65TH ST
Mailing Address - Street 2:APT. 4A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-4170
Mailing Address - Country:US
Mailing Address - Phone:718-627-2702
Mailing Address - Fax:
Practice Address - Street 1:2469 65TH ST
Practice Address - Street 2:APT. 4A
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-4170
Practice Address - Country:US
Practice Address - Phone:718-627-2702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-11
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health