Provider Demographics
NPI:1891813770
Name:DOMINIQUE COZIEN MD PLLC
Entity Type:Organization
Organization Name:DOMINIQUE COZIEN MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DOMINIQUE
Authorized Official - Middle Name:ALAIN
Authorized Official - Last Name:COZIEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-722-7577
Mailing Address - Street 1:142 JORALEMON ST
Mailing Address - Street 2:SUITE 8F
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-4709
Mailing Address - Country:US
Mailing Address - Phone:718-722-7577
Mailing Address - Fax:718-722-9955
Practice Address - Street 1:142 JORALEMON ST
Practice Address - Street 2:SUITE 8F
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-4709
Practice Address - Country:US
Practice Address - Phone:718-722-7577
Practice Address - Fax:718-722-9955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2276972084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYY54135Medicare UPIN
NYWGW321Medicare PIN