Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 006921-1 | NY |
NPI | 1003065335 |
---|---|
Provider Name | Izabella Rozental |
First Address | Yorktown Heights, NY 10598-1100 |
Second Address | Yorktown Heights, NY 10598-1100 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/09/2008 |
Last Update Date | 10/09/2008 |