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General NPI Number Information
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NPI Number | 1619869856
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Entity Type | Organization
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Legal Business Name | VLR MED LLC
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Dates
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Enumeration Date | 07/21/2025
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Last Update Date | 07/21/2025
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Provider Practice Location Address
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Address Line | 194 ROUTE 35
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City | RED BANK
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State | NJ
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Zip | 07701-5935
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Country | US
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Telephone | 347-669-2348
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Fax |
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Provider Business Mailing Address
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Address Line | 716 NEWMAN SPRINGS RD STE 150
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City | LINCROFT
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State | NJ
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Zip | 07738-1523
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Country | US
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Telephone | 347-669-2348
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. DMITRY ROZIN
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Credential | MD
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Telephone | 347-669-2348
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP3000X
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Taxonomy Name | Pediatric Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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