Provider Demographics
NPI:1508231515
Name:ROZENBAUM, ANNA
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:ROZENBAUM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 KINGS PL
Mailing Address - Street 2:APT. 5C
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-2764
Mailing Address - Country:US
Mailing Address - Phone:646-642-1365
Mailing Address - Fax:
Practice Address - Street 1:11 KINGS PL
Practice Address - Street 2:APT. 5C
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-2764
Practice Address - Country:US
Practice Address - Phone:646-642-1365
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-02
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist