Healthcare Provider Details

I. General information

NPI: 1962507251
Provider Name (Legal Business Name): ASSIF ROZOVSKY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 10/24/2024
Certification Date: 10/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 JACK MARTIN BLVD SUITE 300
BRICK NJ
08724-7737
US

IV. Provider business mailing address

331 NEWMAN SPRINGS RD STE 220
RED BANK NJ
07701-5792
US

V. Phone/Fax

Practice location:
  • Phone: 732-840-0067
  • Fax: 732-840-3169
Mailing address:
  • Phone: 732-807-0877
  • Fax: 201-751-1680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number25MA05918700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: