Healthcare Provider Details

I. General information

NPI: 1801861265
Provider Name (Legal Business Name): ALINA VASILYEVA D.P.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALINA VASILYEVA-ROZINGER D.P.M.

II. Dates (important events)

Enumeration Date: 02/21/2006
Last Update Date: 04/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2116 AVENUE P
BROOKLYN NY
11229-1507
US

IV. Provider business mailing address

1806 VOORHIES AVE #1B
BROOKLYN NY
11235-3648
US

V. Phone/Fax

Practice location:
  • Phone: 718-338-1616
  • Fax: 718-338-1898
Mailing address:
  • Phone: 646-894-4168
  • Fax: 718-331-6720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberN006046
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: