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General NPI Number Information
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NPI Number | 1326288432
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Entity Type | Individual
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Provider Name | MR. BORIS ROZHANSKY
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Gender | Male
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Dates
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Enumeration Date | 03/02/2009
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Last Update Date | 10/05/2023
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Provider Practice Location Address
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Address Line | 98 SAINT JOHNS AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10305-3026
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Country | US
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Telephone | 718-447-9296
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Fax | 718-981-5247
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Provider Business Mailing Address
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Address Line | 98 SAINT JOHNS AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10305-3026
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Country | US
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Telephone | 718-447-9296
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Fax | 718-981-5247
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 006371-1
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License Number State | NY
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