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:
Health care specialties
| Specialty | Code | License # | 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 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1467460865 | NPPES |
| Maryland | MEDICAID | 402464800 | |
| Maryland | MEDICAID | 463350400 |
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