Individual
ILYA YUREVICH KOZLOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1650 GRAND CONCOURSE, BRONX, NY 10457-7606
(718) 239-8383
(718) 239-8360
Mailing address
1650 GRAND CONCOURSE, 5TH FL ADMIN - DEPT OF OBGYN, BRONX, NY 10457-7606
(718) 239-8383
(718) 239-8360
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
230644
NY
Other
Enumeration date
07/05/2006
Last updated
03/28/2018
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