Provider Demographics
NPI:1750390761
Name:ROZIN, ALEKSANDR (MD)
Entity type:Individual
Prefix:
First Name:ALEKSANDR
Middle Name:
Last Name:ROZIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8906 135TH ST
Mailing Address - Street 2:7L
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11418-2834
Mailing Address - Country:US
Mailing Address - Phone:718-206-6984
Mailing Address - Fax:718-206-6786
Practice Address - Street 1:1335 LINDEN BLVD
Practice Address - Street 2:STE 100 TJH MEDICAL SERVICES PC
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-4751
Practice Address - Country:US
Practice Address - Phone:718-240-5100
Practice Address - Fax:418-240-5498
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY222543207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02184792Medicaid
H52997Medicare UPIN
NY02184792Medicaid