Provider Demographics
NPI:1134657356
Name:KOZMINSKI, CHERYL L (RRT)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:L
Last Name:KOZMINSKI
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:666 CAYUGA CREEK RD
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14227-1932
Mailing Address - Country:US
Mailing Address - Phone:716-812-3106
Mailing Address - Fax:
Practice Address - Street 1:95 JOHN MUIR DR
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228-1144
Practice Address - Country:US
Practice Address - Phone:716-250-4137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-01
Last Update Date:2017-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006759-1227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY006759-1OtherRESPIRATORY THERAPIST LICENSE