Provider Demographics
NPI:1841718228
Name:SUZANNE ROZENBERG, DO BROOKLYN PC
Entity type:Organization
Organization Name:SUZANNE ROZENBERG, DO BROOKLYN PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:JANICE
Authorized Official - Last Name:SIROTA ROZENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:516-295-5570
Mailing Address - Street 1:11 IRVING PL
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-1256
Mailing Address - Country:US
Mailing Address - Phone:516-295-5570
Mailing Address - Fax:516-295-5575
Practice Address - Street 1:1270 51ST ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-3661
Practice Address - Country:US
Practice Address - Phone:516-295-5570
Practice Address - Fax:516-295-5575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-06
Last Update Date:2017-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1804801207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Single Specialty