MEDICARE: MRS. KATHLEEN ROSE KOZAR RDN

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	133V00000X	Registered Dietitian	00879448	NY

General Provider Information

NPI Number	:	1538099924
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KATHLEEN ROSE KOZAR RDN

Provider Business Mailing Address
First Line	:	4 LIVINGSTON ST
Second Line	:
City	:	RED HOOK
State	:	NY
Zip	:	12571-1828
Country	:	US
Telephone Number	:	914-323-8062
Fax Number	:

Provider Business Practice Location Address
First Line	:	7180 CAYO COCO LN
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34113-9076
Country	:	US
Telephone Number	:	914-323-8062
Fax Number	:

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

Provider Enumeration Date	:	05/19/2026
Last Update Date	:	05/19/2026

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