Provider Demographics
NPI:1982831046
Name:ROZENBAUM, DINA (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:DINA
Middle Name:
Last Name:ROZENBAUM
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:352 EDWARD AVE
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-2825
Mailing Address - Country:US
Mailing Address - Phone:516-295-4264
Mailing Address - Fax:
Practice Address - Street 1:15915 88TH ST
Practice Address - Street 2:
Practice Address - City:HOWARD BEACH
Practice Address - State:NY
Practice Address - Zip Code:11414-3037
Practice Address - Country:US
Practice Address - Phone:718-848-2700
Practice Address - Fax:718-848-4226
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-16
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0167821235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist