Healthcare Provider Details

I. General information

NPI: 1275931594
Provider Name (Legal Business Name): ROZ REACHING OUT FOR ZEAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2014
Last Update Date: 12/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2770 DEWEY AVE APT 6D
BRONX NY
10465-2846
US

IV. Provider business mailing address

2770 DEWEY AVE
BRONX NY
10465-2860
US

V. Phone/Fax

Practice location:
  • Phone: 646-506-2694
  • Fax:
Mailing address:
  • Phone: 646-506-2694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: MS. APRIL GORDON
Title or Position: FOUNDER/PRESIDENT
Credential:
Phone: 646-506-2694