Healthcare Provider Details

I. General information

NPI: 1477517480
Provider Name (Legal Business Name): NANCY JEAN ROIZEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NANCY J. MRAZEK M.D.

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 08/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10524 EUCLID AVE
CLEVELAND OH
44106-2205
US

IV. Provider business mailing address

24701 EUCLID AVE 3RD FLOOR
EUCLID OH
44117-1714
US

V. Phone/Fax

Practice location:
  • Phone: 216-844-3230
  • Fax: 216-201-5188
Mailing address:
  • Phone: 216-844-3230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number35086672
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number35-086672
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: