Healthcare Provider Details

I. General information

NPI: 1699121954
Provider Name (Legal Business Name): ORYSIA KOZICKY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2016
Last Update Date: 06/30/2022
Certification Date: 06/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 DELAFIELD RD STE 4040
PITTSBURGH PA
15215-3235
US

IV. Provider business mailing address

200 DELAFIELD RD STE 4040
PITTSBURGH PA
15215-3235
US

V. Phone/Fax

Practice location:
  • Phone: 412-784-1466
  • Fax: 412-784-1992
Mailing address:
  • Phone: 412-784-1466
  • Fax: 412-784-1992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberMD469960
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: