Healthcare Provider Details

I. General information

NPI: 1821051319
Provider Name (Legal Business Name): KAREN MARIE ROZYCKI O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2006
Last Update Date: 07/10/2023
Certification Date: 07/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 W CHESTNUT ST
WASHINGTON PA
15301-4423
US

IV. Provider business mailing address

30 BELLVIEW DR
AVELLA PA
15312-2453
US

V. Phone/Fax

Practice location:
  • Phone: 724-225-4448
  • Fax: 724-225-7237
Mailing address:
  • Phone: 724-225-4448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOE007737T
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOE007737-T
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: