Provider Demographics
NPI:1366487092
Name:MALICKA-ROZEK, BARBARA J (MD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:J
Last Name:MALICKA-ROZEK
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2101 KIMBALL AVE
Mailing Address - Street 2:LL14
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50702-5063
Mailing Address - Country:US
Mailing Address - Phone:319-272-1590
Mailing Address - Fax:319-272-1535
Practice Address - Street 1:3421 W 9TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50702-5401
Practice Address - Country:US
Practice Address - Phone:319-272-7469
Practice Address - Fax:319-272-7868
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2007-07-16
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Provider Licenses
StateLicense IDTaxonomies
IA32558208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1178269Medicaid
IA20999Medicare PIN
IA1178269Medicaid