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NPI Code Detail

MEDICARE: DR. SHONI JAYE ROZENBERG D.O.

MEDICARE: DR. SHONI JAYE ROZENBERG D.O.
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
1207N00000XDermatology Physician286082NY
2390200000XStudent in an Organized Health Care Education/Training Program688233649NY

General Provider Information

NPI Number : 1902284854
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHONI JAYE ROZENBERG D.O.
Provider Business Mailing Address
First Line : 11 IRVING PL
Second Line :
City : WOODMERE
State : NY
Zip : 11598-1256
Country : US
Telephone Number : 516-295-5570
Fax Number :
Provider Business Practice Location Address
First Line : 11 IRVING PL
Second Line :
City : WOODMERE
State : NY
Zip : 11598-1256
Country : US
Telephone Number : 516-295-5570
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2015
Last Update Date : 03/25/2024

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