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Individual

ALIZA KOSYAKOVSKY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
55 FRUIT ST, BOSTON, MA 02114-2621
(617) 724-1400
(617) 643-7035
Mailing address
77 PARK DR APT 20, BOSTON, MA 02215-5225

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2361292
MA
363LA2200X
Adult Health Nurse Practitioner
98864
ZZ

Other

Enumeration date
02/01/2022
Last updated
04/08/2026
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