Provider Demographics
NPI:1205195062
Name:KOZMA, ALEKSANDR
Entity Type:Individual
Prefix:
First Name:ALEKSANDR
Middle Name:
Last Name:KOZMA
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 1:3103 PHILMONT AVENUE
Mailing Address - Street 2:SUITE 350
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-4263
Mailing Address - Country:US
Mailing Address - Phone:267-407-2666
Mailing Address - Fax:
Practice Address - Street 1:3103 PHILMONT AVENUE
Practice Address - Street 2:SUITE 350
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-4263
Practice Address - Country:US
Practice Address - Phone:267-407-2666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-14
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
120143416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport