| Dr Rozana Itskovich | |
|
7660 E Parham Road Suite 204 Richmond VA 23294 | |
| (804) 364-8802 | |
| (804) 364-1288 |
| Full Name | Dr Rozana Itskovich |
|---|---|
| Speciality | Internal Medicine |
| Location | 7660 E Parham Road, Richmond, Virginia |
| Authorized Official Name and Position | Gregory Itskovich (VICE PRESIDENT) |
| Authorized Official Contact | 8043648802 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Rozana Itskovich Po Box 28645 Richmond VA 23228 Ph: (804) 364-8802 | Dr Rozana Itskovich 7660 E Parham Road Suite 204 Richmond VA 23294 Ph: (804) 364-8802 |
| NPI Number | 1003901257 |
|---|---|
| Provider Enumeration Date | 10/04/2006 |
| Last Update Date | 11/30/2007 |
| Medicare PECOS PAC ID | 4688799000 |
|---|---|
| Medicare Enrollment ID | O20100908001063 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003901257 | NPI | - | NPPES |
| 5863848 | Medicaid | VA | |
| 1291545964657 | Other | VA | AETNA |
| 258592 | Other | VA | ANTHEM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 0101058429 (Virginia) | Primary |
| Provider Name | Rozana Itskovich |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386829232 PECOS PAC ID: 1658495213 Enrollment ID: I20100902000998 |
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