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General NPI Number Information
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NPI Number | 1790978955
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Entity Type | Individual
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Provider Name | ANNA V ROZENTUL D.O.
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Gender | Female
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Dates
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Enumeration Date | 08/21/2007
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Last Update Date | 06/19/2020
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Provider Practice Location Address
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Address Line | 2175 86TH ST
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City | BROOKLYN
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State | NY
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Zip | 11214-3205
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Country | US
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Telephone | 646-828-6401
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Fax | 646-828-6403
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Provider Business Mailing Address
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Address Line | 135 SEA BREEZE AVE STE 101
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City | BROOKLYN
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State | NY
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Zip | 11224-3701
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Country | US
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Telephone | 718-338-0300
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Fax | 718-513-0434
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25MB10058000
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 250561
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License Number State | NY
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