Organization
MATTHEW KOZMINSKI DO PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW KOZMINSKI DO (DIRECTOR)
(814) 330-5061
Entity
Organization
Contact information
Practice address
215 E 1ST AVE, TARENTUM, PA 15084-1765
(724) 749-4118
(724) 202-0394
Mailing address
238 BEAR CREEK RD, PROSPECT, PA 16052-3204
(814) 330-5061
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1649303108
INDIVIDUAL PROVIDER
PA
Enumeration date
09/23/2020
Last updated
09/23/2020
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