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NPI Code Detail

MEDICARE: DR. ALEXANDER ROYZENBLAT

MEDICARE: DR. ALEXANDER ROYZENBLAT
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
1122300000XDentist4278SC
21223G0001XGeneral Practice Dentistry2901018211MI
31223E0200XEndodontics6495-15WI
4122300000XDentist019028225IL
5122300000XDentist49796CA
61223E0200XEndodontics0401414365VA

General Provider Information

NPI Number : 1588635072
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALEXANDER ROYZENBLAT
Provider Business Mailing Address
First Line : 903 HENPHIL FARMS CT
Second Line :
City : CHESAPEAKE
State : VA
Zip : 23320-8199
Country : US
Telephone Number : 760-613-3917
Fax Number :
Provider Business Practice Location Address
First Line : 1721 ADMIRAL TAUSSIG BLVD
Second Line : SEWELL'S POINT BRANCH MEDICAL CLINIC
City : NORFOLK
State : VA
Zip : 23511-2802
Country : US
Telephone Number : 760-613-3917
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2006
Last Update Date : 10/18/2014

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Directions to “ DR. ALEXANDER ROYZENBLAT ” Practice Location

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