Provider Demographics
NPI:1407616360
Name:KOZINA, ERIK (MD)
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:
Last Name:KOZINA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3231 EUCLID AVE FL 5
Mailing Address - Street 2:
Mailing Address - City:BERWYN
Mailing Address - State:IL
Mailing Address - Zip Code:60402-4603
Mailing Address - Country:US
Mailing Address - Phone:877-834-7264
Mailing Address - Fax:
Practice Address - Street 1:3231 EUCLID AVE FL 5
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402-4603
Practice Address - Country:US
Practice Address - Phone:877-834-7264
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program