Provider Demographics
NPI:1932312725
Name:ROZENBERG, SVETLANA (DDS)
Entity type:Individual
Prefix:DR
First Name:SVETLANA
Middle Name:
Last Name:ROZENBERG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 W 54TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-5404
Mailing Address - Country:US
Mailing Address - Phone:212-265-7724
Mailing Address - Fax:212-333-7431
Practice Address - Street 1:45 WEST 54 ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019
Practice Address - Country:US
Practice Address - Phone:212-265-7724
Practice Address - Fax:212-333-7431
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045553-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist