Provider Demographics
NPI:1326172255
Name:COX-IYAMU, ROXANNE D (MD)
Entity Type:Individual
Prefix:DR
First Name:ROXANNE
Middle Name:D
Last Name:COX-IYAMU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6255 W SUNSET BLVD FL 21
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90028-7422
Mailing Address - Country:US
Mailing Address - Phone:323-860-5200
Mailing Address - Fax:323-467-7119
Practice Address - Street 1:16121 JAMAICA AVE FL 7
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-6113
Practice Address - Country:US
Practice Address - Phone:929-421-4630
Practice Address - Fax:347-532-2328
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCMD19457207RI0200X
NY265255-01207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY06168198Medicaid
DC4564005Medicaid