Healthcare Provider Details

I. General information

NPI: 1922794981
Provider Name (Legal Business Name): MARIJANA KOZESKA PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2023
Last Update Date: 04/13/2023
Certification Date: 04/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 HIGHWAY 35
RED BANK NJ
07701-5920
US

IV. Provider business mailing address

270 HIGHWAY 35
RED BANK NJ
07701-5920
US

V. Phone/Fax

Practice location:
  • Phone: 732-842-7477
  • Fax: 732-924-9065
Mailing address:
  • Phone: 732-842-7477
  • Fax: 732-924-9065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI04301400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: