Provider Demographics
NPI:1063414431
Name:ROIZIN, JOHN (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:ROIZIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 S COMMERCE WAY
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-8992
Mailing Address - Country:US
Mailing Address - Phone:484-821-0821
Mailing Address - Fax:484-821-0826
Practice Address - Street 1:31 S COMMERCE WAY
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-8992
Practice Address - Country:US
Practice Address - Phone:484-821-0821
Practice Address - Fax:484-821-0826
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD061164L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016687480007Medicaid
PA0016687480007Medicaid
G92080Medicare PIN