Rozenberg, Ilya

Rozenberg, Ilya is an sole proprietor health care provider with primary practice located at 7452 Baltimore Annapolis Blvd Suite 107, Glen Burnie MD 21061-3547. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as his primary health care specialty. Rozenberg, Ilya can be contacted via phone (410) 766-1544.

Contact Information

Primary practice address
7452 Baltimore Annapolis Blvd Suite 107 Glen Burnie MD 21061-3547
Phone: (410) 766-1544
Fax: (410) 766-1551
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X R143360 Maryland

Profile Details

NPI number 1467460865
LBN Legal business name Rozenberg, Ilya
Credentials MS/CRNP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 3rd, 2006
Last updated Oct 3rd, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467460865 NPPES
Maryland MEDICAID 402464800
Maryland MEDICAID 463350400

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