Individual
KATIE KOZACKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
900 DOUGLAS PIKE FL 1, SMITHFIELD, RI 02917-1879
(401) 649-4050
(401) 649-4051
Mailing address
15 LA SALLE SQ, PROVIDENCE, RI 02903-1814
(401) 444-6779
(401) 444-6912
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD18434
RI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/26/2019
Last updated
03/05/2026
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