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General NPI Number Information
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NPI Number | 1659753754
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Entity Type | Individual
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Provider Name | MEGAN KOZAK RD
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Gender | Female
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Dates
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Enumeration Date | 06/24/2015
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Last Update Date | 05/23/2024
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Provider Practice Location Address
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Address Line | 7201 4TH AVE APT D9
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City | BROOKLYN
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State | NY
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Zip | 11209-2512
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Country | US
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Telephone | 646-467-2771
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Fax |
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Provider Business Mailing Address
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Address Line | 7201 4TH AVE APT D9
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City | BROOKLYN
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State | NY
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Zip | 11209-2512
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Country | US
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Telephone | 646-467-2771
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 007763-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 172M00000X
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Taxonomy Name | Mechanotherapist
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License Number | 026100-1
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 026100-1
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License Number State | NY
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