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NPI Code Detail

MEDICARE: JACOB NATHAN ROZENCWAIG PHARMD.

MEDICARE: JACOB NATHAN ROZENCWAIG PHARMD.
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
1183500000XPharmacist28RI03028000NJ
21835P1200XPharmacotherapy Pharmacist28RI03028000NJ

General Provider Information

NPI Number : 1477533743
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACOB NATHAN ROZENCWAIG PHARMD.
Provider Business Mailing Address
First Line : 272 HOLDRIDGE AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10312-5432
Country : US
Telephone Number : 718-948-8195
Fax Number :
Provider Business Practice Location Address
First Line : 136 CENTRAL AVE
Second Line :
City : CLARK
State : NJ
Zip : 07066-1142
Country : US
Telephone Number : 732-574-9015
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2006
Last Update Date : 09/11/2025

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