Provider Demographics
NPI:1982860219
Name:ROZINSKI, SUSAN ELLEN
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:ELLEN
Last Name:ROZINSKI
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 1:111 WESTFALL RD
Mailing Address - Street 2:ROOM 154
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-4647
Mailing Address - Country:US
Mailing Address - Phone:585-753-5177
Mailing Address - Fax:585-753-5033
Practice Address - Street 1:111 WESTFALL RD
Practice Address - Street 2:ROOM 154
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-4647
Practice Address - Country:US
Practice Address - Phone:585-753-5177
Practice Address - Fax:585-753-5033
Is Sole Proprietor?:No
Enumeration Date:2008-08-06
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY212225-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse