Healthcare Provider Details

I. General information

NPI: 1578133963
Provider Name (Legal Business Name): MAX ROZENBERG RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2021
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 RESERVOIR RD NW
WASHINGTON DC
20007-2113
US

IV. Provider business mailing address

2141 I ST NW APT 503
WASHINGTON DC
20037-2365
US

V. Phone/Fax

Practice location:
  • Phone: 202-444-2000
  • Fax:
Mailing address:
  • Phone: 917-678-3147
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number0024187424
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberRN1062381
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: