Provider Demographics
NPI:1003192741
Name:KOZINA SINGH, BEATA IWONA (LPN)
Entity Type:Individual
Prefix:MRS
First Name:BEATA
Middle Name:IWONA
Last Name:KOZINA SINGH
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:KOZINA SINGH
Other - Middle Name:BEATA
Other - Last Name:IWONA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1037 N PUTNAM AVE
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11757-2227
Mailing Address - Country:US
Mailing Address - Phone:631-742-8572
Mailing Address - Fax:
Practice Address - Street 1:1037 N PUTNAM AVE
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:NY
Practice Address - Zip Code:11757-2227
Practice Address - Country:US
Practice Address - Phone:631-742-8572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-26
Last Update Date:2018-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY306734-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse