Provider Demographics
NPI:1790977155
Name:ROYZMAN, YAKOV M (DDS)
Entity Type:Individual
Prefix:DR
First Name:YAKOV
Middle Name:M
Last Name:ROYZMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 W 71ST ST
Mailing Address - Street 2:SUITE# 1G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-3802
Mailing Address - Country:US
Mailing Address - Phone:212-579-0552
Mailing Address - Fax:212-570-6203
Practice Address - Street 1:145 W 71ST ST
Practice Address - Street 2:SUITE# 1G
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-3802
Practice Address - Country:US
Practice Address - Phone:212-579-0552
Practice Address - Fax:212-570-6203
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-09
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0454661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice