Provider Demographics
NPI:1932446747
Name:ROZENBERG, NATALYA A (PHARMD)
Entity Type:Individual
Prefix:
First Name:NATALYA
Middle Name:A
Last Name:ROZENBERG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 PROMINENCE POINT PKWY
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30114-9008
Mailing Address - Country:US
Mailing Address - Phone:770-720-4825
Mailing Address - Fax:770-720-4581
Practice Address - Street 1:120 PROMINENCE POINT PKWY
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30114-9008
Practice Address - Country:US
Practice Address - Phone:770-720-4825
Practice Address - Fax:770-720-4581
Is Sole Proprietor?:No
Enumeration Date:2013-01-14
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH024924183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist