Provider Demographics
NPI:1588809818
Name:ROSELYN MARZA WROBLEWSKI DPM. PC
Entity type:Organization
Organization Name:ROSELYN MARZA WROBLEWSKI DPM. PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROSELYN
Authorized Official - Middle Name:MARZA
Authorized Official - Last Name:WROBLEWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:212-724-2622
Mailing Address - Street 1:PO BOX 286245
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-0003
Mailing Address - Country:US
Mailing Address - Phone:212-724-2622
Mailing Address - Fax:646-448-9393
Practice Address - Street 1:1 GUSTAVE L LEVY PL
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6504
Practice Address - Country:US
Practice Address - Phone:212-724-2622
Practice Address - Fax:646-448-9393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-16
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005426213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03124081Medicaid
NY03124081Medicaid