Provider Demographics
NPI:1528114915
Name:ROSZEL, SUSAN C (REGISTERED DIETICIAN)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:C
Last Name:ROSZEL
Suffix:
Gender:F
Credentials:REGISTERED DIETICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 635156
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5156
Mailing Address - Country:US
Mailing Address - Phone:513-528-5600
Mailing Address - Fax:513-528-9716
Practice Address - Street 1:436 OHIO PIKE
Practice Address - Street 2:SUITE 300
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-0000
Practice Address - Country:US
Practice Address - Phone:513-528-5600
Practice Address - Fax:513-528-9716
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD.3999133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP00942817OtherRAILROAD MEDICARE
OHP00159620OtherMEDICARE RAILROAD
ROMT02371Medicare ID - Type Unspecified
OHP00159620OtherMEDICARE RAILROAD