Provider Demographics
NPI:1134141120
Name:ROZEA, GERARD D (PHD)
Entity type:Individual
Prefix:DR
First Name:GERARD
Middle Name:D
Last Name:ROZEA
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1403 SPRING LN
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18301-3130
Mailing Address - Country:US
Mailing Address - Phone:570-421-5934
Mailing Address - Fax:570-422-3616
Practice Address - Street 1:200 PROSPECT ST
Practice Address - Street 2:3 KOHLER FIELDHOUSE UNIVERSITY
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18301
Practice Address - Country:US
Practice Address - Phone:570-422-3065
Practice Address - Fax:570-422-3616
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART001654A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer