Organization
CENTRE DERMATOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK E KOZMINSKY M.D. (OWNER)
(814) 237-6600
Entity
Organization
Contact information
Practice address
2505 GREEN TECH DR STE A1, STATE COLLEGE, PA 16803-2316
(814) 237-6600
Mailing address
2505 GREEN TECH DR STE A1, STATE COLLEGE, PA 16803-2316
(814) 237-6600
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD-033463-E
PA
Other
Enumeration date
08/31/2006
Last updated
08/22/2020
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