Provider Demographics
NPI:1144015330
Name:WROTZLOVSKY, SIMCHA
Entity type:Individual
Prefix:
First Name:SIMCHA
Middle Name:
Last Name:WROTZLOVSKY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1312 AVENUE N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-5906
Mailing Address - Country:US
Mailing Address - Phone:347-964-2940
Mailing Address - Fax:
Practice Address - Street 1:1312 AVENUE N
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-5906
Practice Address - Country:US
Practice Address - Phone:347-964-2940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-10
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst