Healthcare Provider Details

I. General information

NPI: 1932318912
Provider Name (Legal Business Name): SYLVIA ROZANSKI LEE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 07/12/2021
Certification Date: 07/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13204 HULL STREET RD
MIDLOTHIAN VA
23112-2620
US

IV. Provider business mailing address

14418 FOUNTAIN VIEW DR
MIDLOTHIAN VA
23112-4392
US

V. Phone/Fax

Practice location:
  • Phone: 804-223-5437
  • Fax: 804-999-0369
Mailing address:
  • Phone: 804-370-6524
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101240185
License Number StateVA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: