Healthcare Provider Details

I. General information

NPI: 1720280100
Provider Name (Legal Business Name): KOZAUER AND KOZAUER PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2007
Last Update Date: 02/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 N WASHINGTON ST SUITE 208
ROCKVILLE MD
20850-2223
US

IV. Provider business mailing address

14225 POPLAR HILL RD
DARNESTOWN MD
20874-3562
US

V. Phone/Fax

Practice location:
  • Phone: 301-208-0930
  • Fax: 301-424-3027
Mailing address:
  • Phone: 240-683-5730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. NICHOLAS KOZAUER
Title or Position: OWNER
Credential: MD
Phone: 410-822-6175