Provider Demographics
NPI:1487122107
Name:ROZMAN, IRINA
Entity type:Individual
Prefix:
First Name:IRINA
Middle Name:
Last Name:ROZMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:278 BEACH 141ST ST
Mailing Address - Street 2:
Mailing Address - City:ROCKAWAY PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11694-1230
Mailing Address - Country:US
Mailing Address - Phone:646-220-8707
Mailing Address - Fax:
Practice Address - Street 1:278 BEACH 141ST ST
Practice Address - Street 2:
Practice Address - City:ROCKAWAY PARK
Practice Address - State:NY
Practice Address - Zip Code:11694-1230
Practice Address - Country:US
Practice Address - Phone:646-220-8707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-12
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty