Provider Demographics
NPI:1760896922
Name:HAZOGLOU, ROSEMARIE (DO)
Entity Type:Individual
Prefix:
First Name:ROSEMARIE
Middle Name:
Last Name:HAZOGLOU
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ROSEMARIE
Other - Middle Name:
Other - Last Name:MULE'
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 GARDEN CITY PLZ
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-3301
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 GARDEN CITY PLZ
Practice Address - Street 2:SUITE 100
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-3301
Practice Address - Country:US
Practice Address - Phone:151-666-3640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-16
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY260536-1207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology