Provider Demographics
NPI:1295026516
Name:KOSCIELNA, KATARZYNA M (DO)
Entity Type:Individual
Prefix:
First Name:KATARZYNA
Middle Name:M
Last Name:KOSCIELNA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:178 N 8TH ST APT 3R
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-2006
Mailing Address - Country:US
Mailing Address - Phone:917-763-7556
Mailing Address - Fax:
Practice Address - Street 1:178 N 8TH ST APT 3R
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-2006
Practice Address - Country:US
Practice Address - Phone:917-763-7556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-20
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY261034-1207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine