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NPI Code Detail

MEDICARE: MARIA I KOSTRZEWSKI M.D.

MEDICARE: MARIA I KOSTRZEWSKI M.D.
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
12084P0800XPsychiatry Physician35076359KOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1629067814
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIA I KOSTRZEWSKI M.D.
Provider Business Mailing Address
First Line : 6605 W CENTRAL AVE
Second Line : STE 100
City : TOLEDO
State : OH
Zip : 43617-1000
Country : US
Telephone Number : 419-693-0631
Fax Number :
Provider Business Practice Location Address
First Line : 544 E WOODRUFF AVE
Second Line :
City : TOLEDO
State : OH
Zip : 43604-5342
Country : US
Telephone Number : 419-693-0631
Fax Number : 419-936-7606
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2005
Last Update Date : 09/12/2016

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Directions to “ MARIA I KOSTRZEWSKI M.D.” Practice Location

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