Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OP006188 | PA |
NPI | 1003096603 |
---|---|
Provider Name | John A Rozgonyi |
First Address | Munhall, PA 15120-3272 |
Second Address | Braddock, PA 15104-1599 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/11/2007 |
Last Update Date | 12/11/2007 |