Healthcare Provider Details

I. General information

NPI: 1073650230
Provider Name (Legal Business Name): MARIANN KOCSIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 RESERVATION RD
RENO NV
89502-1521
US

IV. Provider business mailing address

3010 REUBEN DR
RENO NV
89502-4928
US

V. Phone/Fax

Practice location:
  • Phone: 775-329-5162
  • Fax:
Mailing address:
  • Phone: 775-828-4280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License NumberPR4428
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: