Healthcare Provider Details

I. General information

NPI: 1982928511
Provider Name (Legal Business Name): CHRISTINA TORRES KOZYCKI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2010
Last Update Date: 08/08/2023
Certification Date: 08/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CENTER DRIVE BUILDING 10
BETHESDA MD
20892-1852
US

IV. Provider business mailing address

10 CENTER DRIVE BUILDING 10, ROOM B3-4156
BETHESDA MD
20892-1852
US

V. Phone/Fax

Practice location:
  • Phone: 706-333-4049
  • Fax: 301-480-5108
Mailing address:
  • Phone: 706-333-4049
  • Fax: 301-480-5108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD046197
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberMD046197
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: