Healthcare Provider Details

I. General information

NPI: 1619869856
Provider Name (Legal Business Name): VLR MED LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2025
Last Update Date: 07/21/2025
Certification Date: 07/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

194 ROUTE 35
RED BANK NJ
07701-5935
US

IV. Provider business mailing address

716 NEWMAN SPRINGS RD STE 150
LINCROFT NJ
07738-1523
US

V. Phone/Fax

Practice location:
  • Phone: 347-669-2348
  • Fax:
Mailing address:
  • Phone: 347-669-2348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DMITRY ROZIN
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 347-669-2348