Healthcare Provider Details

I. General information

NPI: 1770646200
Provider Name (Legal Business Name): DR. ALAIN ROIZEN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 CENTRAL PARK S 9TH FLOOR
NEW YORK NY
10019-1628
US

IV. Provider business mailing address

30 CENTRAL PARK S 9TH FLOOR
NEW YORK NY
10019-1628
US

V. Phone/Fax

Practice location:
  • Phone: 212-319-5002
  • Fax: 212-319-3064
Mailing address:
  • Phone: 212-319-5002
  • Fax: 212-319-3064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number032045
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: