Provider Demographics
NPI:1144381260
Name:WROBLEWSKI, ROSELYN MARZA (DPM)
Entity Type:Individual
Prefix:DR
First Name:ROSELYN
Middle Name:MARZA
Last Name:WROBLEWSKI
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-3000
Mailing Address - Country:US
Mailing Address - Phone:917-301-8996
Mailing Address - Fax:646-308-1142
Practice Address - Street 1:141 W 73RD ST
Practice Address - Street 2:APT 1N
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-2916
Practice Address - Country:US
Practice Address - Phone:212-724-2622
Practice Address - Fax:646-308-1142
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005426213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01826695Medicaid
NYU69950Medicare UPIN
NY01826695Medicaid
NYPA1692Medicare ID - Type Unspecified