MEDICARE: LARA KOZIN DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	25MD00348300	NJ

General Provider Information

NPI Number	:	1235584616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LARA KOZIN DPM

Provider Business Mailing Address
First Line	:	2265 SOUTH AVE
Second Line	:
City	:	SCOTCH PLAINS
State	:	NJ
Zip	:	07076-4635
Country	:	US
Telephone Number	:	908-232-3346
Fax Number	:	908-232-6920

Provider Business Practice Location Address
First Line	:	2265 SOUTH AVE
Second Line	:
City	:	SCOTCH PLAINS
State	:	NJ
Zip	:	07076-4635
Country	:	US
Telephone Number	:	908-232-3346
Fax Number	:	908-232-6920

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2016
Last Update Date	:	05/13/2022

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Directions to “ LARA KOZIN DPM” Practice Location

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