Provider Demographics
NPI:1386677680
Name:ROVNO, HAZEL D (MD)
Entity Type:Individual
Prefix:
First Name:HAZEL
Middle Name:D
Last Name:ROVNO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HAZEL
Other - Middle Name:DIANE SARAH
Other - Last Name:ROVNO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5 INDIAN RUN
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-1082
Mailing Address - Country:US
Mailing Address - Phone:908-229-4060
Mailing Address - Fax:
Practice Address - Street 1:5 INDIAN RUN
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08648-1082
Practice Address - Country:US
Practice Address - Phone:952-595-1100
Practice Address - Fax:612-294-4903
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD062685L2085R0202X
NJ25MA059316002085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology