Provider Demographics
NPI:1841356839
Name:ROZANSKI, THOMAS I (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:I
Last Name:ROZANSKI
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 1:445 HURFFVILLE CROSS KEYS RD
Mailing Address - Street 2:STE B14
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080
Mailing Address - Country:US
Mailing Address - Phone:856-589-4545
Mailing Address - Fax:856-589-6210
Practice Address - Street 1:445 HURFFVILLE CROSS KEYS RD
Practice Address - Street 2:B14
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080
Practice Address - Country:US
Practice Address - Phone:856-589-4545
Practice Address - Fax:856-589-6210
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJ16130207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2358506Medicaid
C53226Medicare UPIN
NJ098802Medicare ID - Type Unspecified