Provider Demographics
NPI:1336324664
Name:SZOSTAK, KATARZYNA IZABELA
Entity Type:Individual
Prefix:
First Name:KATARZYNA
Middle Name:IZABELA
Last Name:SZOSTAK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9902 3RD AVE APT 5W
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-7924
Mailing Address - Country:US
Mailing Address - Phone:646-206-4036
Mailing Address - Fax:
Practice Address - Street 1:459 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-3001
Practice Address - Country:US
Practice Address - Phone:212-219-2658
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-05
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052100-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist