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NPI Code Detail

MEDICARE: LISA KOZLOWSKI MD

MEDICARE: LISA KOZLOWSKI MD
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
1207YX0901XOtology & Neurotology Physician179577NY
2207RC0000XCardiovascular Disease Physician179577NY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2RB6955OTHERMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
100040270604OTHERUNIVERA
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
42198090OTHERINDEPENDENT HEALTH

General Provider Information

NPI Number : 1548248834
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA KOZLOWSKI MD
Provider Business Mailing Address
First Line : 425 ESSJAY RD STE 170
Second Line :
City : WILLIAMSVILLE
State : NY
Zip : 14221-5782
Country : US
Telephone Number : 716-630-1219
Fax Number :
Provider Business Practice Location Address
First Line : 325 ESSJAY RD
Second Line :
City : WILLIAMSVILLE
State : NY
Zip : 14221-8243
Country : US
Telephone Number : 716-630-1146
Fax Number : 716-817-1730
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2006
Last Update Date : 12/20/2021

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Directions to “ LISA KOZLOWSKI MD” Practice Location

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