MEDICARE: DR. ILANA GINSBURG HROZENCIK OD

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	152W00000X	Optometrist	003015	GA

General Provider Information

NPI Number	:	1306366828
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ILANA GINSBURG HROZENCIK OD

Provider Business Mailing Address
First Line	:	3479 MEMORIAL DRIVE
Second Line	:	SUITE A AND B
City	:	DECATUR
State	:	GA
Zip	:	30032
Country	:	US
Telephone Number	:	404-534-1222
Fax Number	:	404-534-1242

Provider Business Practice Location Address
First Line	:	2891 N DECATUR RD STE F
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30033-7426
Country	:	US
Telephone Number	:	404-534-1222
Fax Number	:

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

Provider Enumeration Date	:	06/26/2017
Last Update Date	:	04/10/2026

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