Provider Demographics
NPI:1932438652
Name:J KOZLOWSKI MD PA
Entity Type:Organization
Organization Name:J KOZLOWSKI MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:KOZLOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-350-3460
Mailing Address - Street 1:17725 CIRCLE POND CT
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33496-1017
Mailing Address - Country:US
Mailing Address - Phone:561-350-3460
Mailing Address - Fax:561-852-1960
Practice Address - Street 1:17725 CIRCLE POND CT
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33496-1017
Practice Address - Country:US
Practice Address - Phone:561-350-3460
Practice Address - Fax:561-852-1960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-08
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty