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Individual

DR. PAUL M KOSLOW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
8911 63RD DR, REGO PARK, NY 11374-3852
(718) 639-9887
(718) 457-5308
Mailing address
8911 63RD DR, REGO PARK, NY 11374-3852
(718) 639-9887
(718) 457-5308

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
N005473
NY
213ES0131X
Foot Surgery Podiatrist
Primary
N005473
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01945371
NY
01
1499548
GHI
NY
Enumeration date
06/07/2006
Last updated
08/23/2010
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