Healthcare Provider Details

I. General information

NPI: 1558416578
Provider Name (Legal Business Name): RAMA ZWILLENBERG KOSLOWE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 03/07/2023
Certification Date: 03/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27-31 NEW DORP LANE
STATEN ISLAND NY
10306
US

IV. Provider business mailing address

97 NEW DORP LN SUITE A
STATEN ISLAND NY
10306-2364
US

V. Phone/Fax

Practice location:
  • Phone: 718-668-1000
  • Fax: 718-351-2085
Mailing address:
  • Phone: 718-876-6220
  • Fax: 718-876-5969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number147235
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: