Provider Demographics
NPI:1689657017
Name:ROZRAN, NANCY G (DPM)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:G
Last Name:ROZRAN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 HEMPSTEAD AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-2043
Mailing Address - Country:US
Mailing Address - Phone:516-766-3258
Mailing Address - Fax:516-766-8604
Practice Address - Street 1:414 HEMPSTEAD AVE
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-2043
Practice Address - Country:US
Practice Address - Phone:516-766-3258
Practice Address - Fax:516-766-8604
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-21
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN2872213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AB45620OtherMDNY
T50883Medicare UPIN
AB45620OtherMDNY