Healthcare Provider Details

I. General information

NPI: 1932014743
Provider Name (Legal Business Name): MARIANNA KOZIJ LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 W 188 ST
BRONX NY
10468-5001
US

IV. Provider business mailing address

1519 METROPOLITAN AVE APT 3G
BRONX NY
10462-6119
US

V. Phone/Fax

Practice location:
  • Phone: 718-563-0757
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number131354
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: