AMANDA ROSE KOZAKIEWICZ NPI 1669197950

NPI Information

NPI: 1669197950
Provider Name: AMANDA ROSE KOZAKIEWICZ
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
11700 MAIN RD STE 1
MATTITUCK, NY
ZIP 11952
Phone: (631) 624-7839
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Amanda Rose Kozakiewicz is a psychiatric/mental health nurse practitioner in Mattituck, NY with 2 years of experience. Amanda Rose Kozakiewicz NPI is 1669197950. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: STATE UNIVERSITY OF NEW YORK AT STONY BROOK, SCHOOL OF MEDICINE
Graduation Year:2022

The provider's business location address is:

11700 MAIN RD STE 1
MATTITUCK, NY
ZIP 11952-525
Phone: (631) 624-7839

The NPI 1669197950 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/10/2022 and was last updated on 10/10/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	404432	NEW YORK	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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