Provider Demographics
NPI:1326206285
Name:KOKOSZKA, AGNIESZKA (MD)
Entity Type:Individual
Prefix:
First Name:AGNIESZKA
Middle Name:
Last Name:KOKOSZKA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 W 39TH ST
Mailing Address - Street 2:SUITE 1601
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-3614
Mailing Address - Country:US
Mailing Address - Phone:646-661-4117
Mailing Address - Fax:646-661-2112
Practice Address - Street 1:108 W 39TH ST
Practice Address - Street 2:SUITE 1601
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-3614
Practice Address - Country:US
Practice Address - Phone:646-661-4117
Practice Address - Fax:646-661-2112
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-28
Last Update Date:2016-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY233258-12084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology