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General NPI Number Information
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NPI Number | 1558909812
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Entity Type | Organization
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Legal Business Name | GEORGE A KOZMINSKI PHYSICIAN PC
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Dates
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Enumeration Date | 12/18/2019
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Last Update Date | 12/18/2019
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Provider Practice Location Address
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Address Line | 1 OXFORD XING STE 1
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City | NEW HARTFORD
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State | NY
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Zip | 13413-3200
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Country | US
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Telephone | 315-507-4751
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Fax | 315-765-6056
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Provider Business Mailing Address
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Address Line | 1 OXFORD XING STE 1
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City | NEW HARTFORD
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State | NY
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Zip | 13413-3200
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Country | US
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Telephone | 315-507-4751
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Fax | 315-765-6056
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Authorized Official
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Title or Position | OWNER
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Name | GEORGE A KOZMINSKI
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Credential | MD
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Telephone | 315-507-4751
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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