Healthcare Provider Details

I. General information

NPI: 1063414431
Provider Name (Legal Business Name): JOHN ROIZIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2005
Last Update Date: 11/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 S COMMERCE WAY
BETHLEHEM PA
18017-8992
US

IV. Provider business mailing address

31 S COMMERCE WAY
BETHLEHEM PA
18017-8992
US

V. Phone/Fax

Practice location:
  • Phone: 484-821-0821
  • Fax: 484-821-0826
Mailing address:
  • Phone: 484-821-0821
  • Fax: 484-821-0826

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD061164L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: