Individual
MELISSA KOZIATEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
650 COMMACK RD, COMMACK, NY 11725-5404
(212) 639-7900
Mailing address
9 FOX LN, SHOREHAM, NY 11786-2230
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
308817
NY
Other
Enumeration date
07/27/2018
Last updated
07/27/2018
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