MEDICARE: ROZ REACHING OUT FOR ZEAL, INC.

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	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1275931594
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROZ REACHING OUT FOR ZEAL, INC.

Provider Business Mailing Address
First Line	:	2770 DEWEY AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10465-2860
Country	:	US
Telephone Number	:	646-506-2694
Fax Number	:

Provider Business Practice Location Address
First Line	:	2770 DEWEY AVE APT 6D
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10465-2846
Country	:	US
Telephone Number	:	646-506-2694
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER/PRESIDENT
Name	:	MS. APRIL GORDON
Credential	:
Telephone Number	:	646-506-2694

Provider Enumeration Date	:	12/18/2014
Last Update Date	:	12/18/2014

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