Provider Demographics
NPI:1437300308
Name:ROZENBAUM, ANNA (RD, CDN)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:ROZENBAUM
Suffix:
Gender:F
Credentials:RD, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2060 OCEAN AVE
Mailing Address - Street 2:#6A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-7354
Mailing Address - Country:US
Mailing Address - Phone:718-376-4699
Mailing Address - Fax:
Practice Address - Street 1:2060 OCEAN AVE
Practice Address - Street 2:#6A
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-7354
Practice Address - Country:US
Practice Address - Phone:718-376-4699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-09
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003567133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered