Provider Demographics
NPI:1134965254
Name:ROZATI, SAMANTHA ANGELA (OD)
Entity type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:ANGELA
Last Name:ROZATI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:ANGELA
Other - Last Name:MUNCEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:281 POND DR
Mailing Address - Street 2:
Mailing Address - City:HOCKESSIN
Mailing Address - State:DE
Mailing Address - Zip Code:19707-9241
Mailing Address - Country:US
Mailing Address - Phone:302-824-2934
Mailing Address - Fax:
Practice Address - Street 1:5301 LIMESTONE RD STE 128
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-1253
Practice Address - Country:US
Practice Address - Phone:302-239-1933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEI4-0010134152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist