Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 058983 | NY |
NPI | 1013336502 |
---|---|
Provider Name | Dr. Irina Roizin |
First Address | Brooklyn, NY 11235-2305 |
Second Address | Brooklyn, NY 11214-2603 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2014 |
Last Update Date | 25/06/2020 |