Healthcare Provider Details

I. General information

NPI: 1447926605
Provider Name (Legal Business Name): STANLEY KOZEK PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2021
Last Update Date: 08/18/2021
Certification Date: 08/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 SYLVAN WAY
PARSIPPANY NJ
07054-3801
US

IV. Provider business mailing address

24 AYERS LN
CLARK NJ
07066-2202
US

V. Phone/Fax

Practice location:
  • Phone: 973-434-1535
  • Fax: 973-434-1536
Mailing address:
  • Phone: 908-358-9380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number067185
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI03364700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: