MEDICARE: MR. JOHN JAMES ROSZKOWSKI MSW, LSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	S 0500320	OH

General Provider Information

NPI Number	:	1033124748
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN JAMES ROSZKOWSKI MSW, LSW

Provider Business Mailing Address
First Line	:	3081 INDIANOLA AVE APT E
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43202-1301
Country	:	US
Telephone Number	:	614-784-0062
Fax Number	:

Provider Business Practice Location Address
First Line	:	3081 INDIANOLA AVE APT E
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43202-1301
Country	:	US
Telephone Number	:	614-784-0062
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/30/2006
Last Update Date	:	07/08/2007

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