Healthcare Provider Details

I. General information

NPI: 1891781720
Provider Name (Legal Business Name): MARGARET Z KOZAK DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2005
Last Update Date: 10/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 NEWTON SPARTA RD
NEWTON NJ
07860-2795
US

IV. Provider business mailing address

532 LAFAYETTE RD SUITE 300
SPARTA NJ
07871-4411
US

V. Phone/Fax

Practice location:
  • Phone: 973-579-1000
  • Fax: 973-579-3571
Mailing address:
  • Phone: 973-940-0423
  • Fax: 973-940-0399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MB06962100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: