Provider Demographics
NPI:1114438983
Name:KOZDAG GOLD, GULIZ (MD)
Entity Type:Individual
Prefix:DR
First Name:GULIZ
Middle Name:
Last Name:KOZDAG GOLD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GULIZ
Other - Middle Name:
Other - Last Name:KOZDAG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:111 E 210TH ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-2401
Mailing Address - Country:US
Mailing Address - Phone:718-904-2471
Mailing Address - Fax:718-904-3133
Practice Address - Street 1:111 E 210TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2401
Practice Address - Country:US
Practice Address - Phone:718-904-2471
Practice Address - Fax:718-904-3133
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-19
Last Update Date:2022-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY296749207R00000X, 207RC0000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program