Individual
ANDREA D KAZLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
MMC - DEPT. OF MEDICINE, 111 EAST 210TH STREET, BRONX, NY 10467
(718) 920-2961
Mailing address
8715 MYRTLE AVE, GLENDALE, NY 11385-7847
(718) 920-2961
(718) 920-2058
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
005952
NY
Other
Enumeration date
10/26/2006
Last updated
07/08/2007
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