Provider Demographics
NPI:1205033396
Name:ALINA VASILYEVA-ROZINGER, D.P.M., P.C.
Entity Type:Organization
Organization Name:ALINA VASILYEVA-ROZINGER, D.P.M., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALINA
Authorized Official - Middle Name:
Authorized Official - Last Name:VASILYEVA-ROZINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:718-646-0131
Mailing Address - Street 1:1806 VOORHIES AVE
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-3647
Mailing Address - Country:US
Mailing Address - Phone:718-646-0731
Mailing Address - Fax:718-646-0731
Practice Address - Street 1:2116 AVENUE P
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1507
Practice Address - Country:US
Practice Address - Phone:718-646-0131
Practice Address - Fax:718-646-0131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-02
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN006046-01213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02638397Medicaid
NYPQWW21Medicare PIN
NYV03476Medicare UPIN
NY02638397Medicaid