Healthcare Provider Details

I. General information

NPI: 1487624789
Provider Name (Legal Business Name): DANIEL J ROZZO O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/26/2006
Last Update Date: 07/21/2020
Certification Date: 07/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2687 N MEMORIAL DR
LANCASTER OH
43130-1670
US

IV. Provider business mailing address

2687 N MEMORIAL DR
LANCASTER OH
43130-1670
US

V. Phone/Fax

Practice location:
  • Phone: 614-326-0761
  • Fax: 614-326-0798
Mailing address:
  • Phone: 740-687-0530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number3822
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: