Healthcare Provider Details

I. General information

NPI: 1063610343
Provider Name (Legal Business Name): MARIYA ROZENFELD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2007
Last Update Date: 03/31/2021
Certification Date: 03/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 AVENUE P
BROOKLYN NY
11229-1106
US

IV. Provider business mailing address

1300 AVENUE P
BROOKLYN NY
11229-1106
US

V. Phone/Fax

Practice location:
  • Phone: 212-420-2577
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number243381
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: