Provider Demographics
NPI:1922437557
Name:ROZOVSKY, MARINA
Entity Type:Individual
Prefix:
First Name:MARINA
Middle Name:
Last Name:ROZOVSKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:466 FORT LEE RD
Mailing Address - Street 2:1B
Mailing Address - City:LEONIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07605-1148
Mailing Address - Country:US
Mailing Address - Phone:201-417-0293
Mailing Address - Fax:
Practice Address - Street 1:70 GRAND ST
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-5606
Practice Address - Country:US
Practice Address - Phone:914-636-4440
Practice Address - Fax:914-636-5231
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-04
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY089987104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker