Provider Demographics
NPI:1609821727
Name:ROZMYSLOWICZ, MAGDALENA M (MD)
Entity Type:Individual
Prefix:MRS
First Name:MAGDALENA
Middle Name:M
Last Name:ROZMYSLOWICZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CAMBRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:DEPTFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08096-6878
Mailing Address - Country:US
Mailing Address - Phone:609-561-1700
Mailing Address - Fax:
Practice Address - Street 1:301 SPRING GARDEN ROAD
Practice Address - Street 2:
Practice Address - City:ANCORA
Practice Address - State:NJ
Practice Address - Zip Code:08037-9699
Practice Address - Country:US
Practice Address - Phone:609-561-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25M078211002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MA07821100OtherMEDICAL EXAMINERS LICENSE
PAMD423997OtherPENNA. MEDICAL LICENSE
PAMD423997OtherPENNA. MEDICAL LICENSE