Provider Demographics
NPI:1467466029
Name:ROZEN, JAY I (MD)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:I
Last Name:ROZEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4801 WEST 100TH STREET
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211
Mailing Address - Country:US
Mailing Address - Phone:816-276-3493
Mailing Address - Fax:913-491-0411
Practice Address - Street 1:4801 WEST 100TH STREET
Practice Address - Street 2:SUITE 100
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211
Practice Address - Country:US
Practice Address - Phone:816-276-3493
Practice Address - Fax:913-491-0411
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR33382085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOI231546Medicare ID - Type Unspecified
C50742Medicare UPIN