Provider Demographics
NPI:1497732200
Name:ROSKIN, JOAN K (MD)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:K
Last Name:ROSKIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 S OCEAN BLVD
Mailing Address - Street 2:APT 2107
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-6263
Mailing Address - Country:US
Mailing Address - Phone:561-347-8472
Mailing Address - Fax:
Practice Address - Street 1:500 S OCEAN BLVD APT 2107
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-5672
Practice Address - Country:US
Practice Address - Phone:561-347-8472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0951912084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEC12523Medicare UPIN