Provider Demographics
NPI:1306231394
Name:KOSSOFF, MARJORIE BRITT (BS, MD)
Entity Type:Individual
Prefix:DR
First Name:MARJORIE
Middle Name:BRITT
Last Name:KOSSOFF
Suffix:
Gender:F
Credentials:BS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:700 PARK REGENCY PL NE
Mailing Address - Street 2:APARTMENT 1507
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30326-1271
Mailing Address - Country:US
Mailing Address - Phone:404-307-6044
Mailing Address - Fax:
Practice Address - Street 1:ROYAL NORTH SHORE HOSPITAL COMMUNITY HEALTH CENTER
Practice Address - Street 2:2C HERBERT STREET LEVEL 6
Practice Address - City:ST LEONARDS
Practice Address - State:NSW
Practice Address - Zip Code:2065
Practice Address - Country:AU
Practice Address - Phone:6141-860-6909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-06
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZMED0001135728261QR0206X
GA015485261QR0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0206XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mammography