MEDICARE: GRZEGORZ KOZIKOWSKI 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
1	207L00000X	Anesthesiology Physician	222249	NY

Other Identifiers

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

General Provider Information

NPI Number	:	1821090200
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRZEGORZ KOZIKOWSKI M.D.

Provider Business Mailing Address
First Line	:	14222 13TH AVE
Second Line	:
City	:	WHITESTONE
State	:	NY
Zip	:	11357-2319
Country	:	US
Telephone Number	:	718-208-3244
Fax Number	:

Provider Business Practice Location Address
First Line	:	146 NORMAN AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11222-3385
Country	:	US
Telephone Number	:	718-349-1221
Fax Number	:

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

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	04/06/2011

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