Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 054954 | NY |
NPI | 1043487820 |
---|---|
Provider Name | Dr. David A. Koslovsky |
First Address | New York, NY 10065-7215 |
Second Address | New York, NY 10065-7215 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2008 |
Last Update Date | 18/10/2020 |