Provider Demographics
NPI:1912977935
Name:KOZLOWSKI, DARIUSZ W (MD)
Entity Type:Individual
Prefix:
First Name:DARIUSZ
Middle Name:W
Last Name:KOZLOWSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:40 HART STREET
Mailing Address - Street 2:BLDG A
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06052
Mailing Address - Country:US
Mailing Address - Phone:860-224-2447
Mailing Address - Fax:860-826-5845
Practice Address - Street 1:40 HART ST
Practice Address - Street 2:BLDG A, 2ND FLR
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06052-1743
Practice Address - Country:US
Practice Address - Phone:860-224-2447
Practice Address - Fax:860-826-5845
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT035047207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001350470Medicaid