Healthcare Provider Details

I. General information

NPI: 1417336322
Provider Name (Legal Business Name): JENNIFER ANNIE KOZEK PHARMD,RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2015
Last Update Date: 05/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

78 CHURCH ST
FLEMINGTON NJ
08822-1640
US

IV. Provider business mailing address

24 AYERS LN
CLARK NJ
07066-2202
US

V. Phone/Fax

Practice location:
  • Phone: 908-782-2017
  • Fax:
Mailing address:
  • Phone: 908-451-7556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI03012000
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RJ01834
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: