Healthcare Provider Details

I. General information

NPI: 1841712213
Provider Name (Legal Business Name): RHONDA ANN KOZLOW RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 JONES RD
SARATOGA SPRINGS NY
12866-5707
US

IV. Provider business mailing address

234 JONES RD
SARATOGA SPRINGS NY
12866-5707
US

V. Phone/Fax

Practice location:
  • Phone: 518-727-6171
  • Fax:
Mailing address:
  • Phone: 518-727-6171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number538749
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: