Individual
IGOR B ROZENVALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655
(508) 793-6100
(508) 793-6110
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
(508) 334-1977
Taxonomy
Speciality
Code
Description
License number
State
207ZH0000X
Hematology (Pathology) Physician
047360
CT
207ZP0101X
Anatomic Pathology Physician
159101
MA
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
047360
CT
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
159101
MA
Other
Enumeration date
06/02/2006
Last updated
11/05/2020
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