Individual
LISA KOZLOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
325 ESSJAY RD, WILLIAMSVILLE, NY 14221-8243
(716) 630-1146
(716) 817-1730
Mailing address
425 ESSJAY RD STE 170, WILLIAMSVILLE, NY 14221-5782
(716) 630-1219
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
179577
NY
207YX0901X
Otology & Neurotology Physician
179577
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00040270604
UNIVERA
—
05
—
01504856
—
NY
01
—
2198090
INDEPENDENT HEALTH
—
01
—
RB6955
MEDICARE
—
Enumeration date
01/06/2006
Last updated
12/20/2021
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