Basic Information
| Provider Information | |||||||||
| NPI: | 1326172255 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COX-IYAMU | ||||||||
| FirstName: | ROXANNE | ||||||||
| MiddleName: | D | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 16121 JAMAICA AVE FL 7 | ||||||||
| Address2: | |||||||||
| City: | JAMAICA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 114326113 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9294214630 | ||||||||
| FaxNumber: | 3475322328 | ||||||||
| Practice Location | |||||||||
| Address1: | 16121 JAMAICA AVE FL 7 | ||||||||
| Address2: | |||||||||
| City: | JAMAICA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 114326113 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9294214630 | ||||||||
| FaxNumber: | 3475322328 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/15/2007 | ||||||||
| LastUpdateDate: | 08/20/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 08/20/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | MD19457 | DC | N | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | 207RI0200X | 265255-01 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
ID Information
| ID | Type | State | Issuer | Description | 4564005 | 05 | DC | MEDICAID | 06168198 | 05 | NY | MEDICAID |