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NPI Code Detail

MEDICARE: KIRA KOZACHEK

MEDICARE:   KIRA  KOZACHEK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker44SL07300800NJ
2104100000XSocial Worker127558NY

General Provider Information

NPI Number : 1407646276
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIRA KOZACHEK
Provider Business Mailing Address
First Line : PO BOX 217
Second Line :
City : WEST ONEONTA
State : NY
Zip : 13861-0217
Country : US
Telephone Number : 908-670-6180
Fax Number :
Provider Business Practice Location Address
First Line : 215 CLEVELAND AVE
Second Line :
City : HIGHLAND PARK
State : NJ
Zip : 08904-1803
Country : US
Telephone Number : 908-670-6180
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2025
Last Update Date : 06/27/2025

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Directions to “ KIRA KOZACHEK ” Practice Location

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