Healthcare Provider Details

I. General information

NPI: 1013038090
Provider Name (Legal Business Name): JOSEPH A KOZIELSKI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 05/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 WHITE HORSE PIKE SUITE 1
HADDON HEIGHTS NJ
08035-1299
US

IV. Provider business mailing address

17 WHITE HORSE PIKE SUITE 1
HADDON HEIGHTS NJ
08035-1299
US

V. Phone/Fax

Practice location:
  • Phone: 856-547-2323
  • Fax: 856-547-7932
Mailing address:
  • Phone: 856-547-2323
  • Fax: 856-547-7932

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMA34496
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: