Provider Demographics
NPI:1568906337
Name:ROZMARIN, ELEONORA (NP)
Entity Type:Individual
Prefix:
First Name:ELEONORA
Middle Name:
Last Name:ROZMARIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 BRIGHTON BEACH AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-5621
Mailing Address - Country:US
Mailing Address - Phone:718-975-8500
Mailing Address - Fax:
Practice Address - Street 1:1009 BRIGHTON BEACH AVE STE 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-5621
Practice Address - Country:US
Practice Address - Phone:718-975-8500
Practice Address - Fax:718-975-8502
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF308034363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health