Healthcare Provider Details

I. General information

NPI: 1891616389
Provider Name (Legal Business Name): VICTORIA ROZENTHAL
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3009 CHURCH AVE
BROOKLYN NY
11226-4209
US

IV. Provider business mailing address

38 WHITMAN DR
BROOKLYN NY
11234-6703
US

V. Phone/Fax

Practice location:
  • Phone: 718-814-2020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number011433
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: