Healthcare Provider Details

I. General information

NPI: 1578593869
Provider Name (Legal Business Name): AURELIA BARBARA KOZIEL-ANDRZEJEWSKA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 05/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 MAPLE LN
ASHLAND WI
54806-3768
US

IV. Provider business mailing address

1625 MAPLE LN
ASHLAND WI
54806-3768
US

V. Phone/Fax

Practice location:
  • Phone: 715-685-7500
  • Fax: 715-682-2481
Mailing address:
  • Phone: 715-685-7500
  • Fax: 715-682-2481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number45604-020
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: