Provider Demographics
NPI:1124049929
Name:JOZEF, KATHLEEN (DC)
Entity type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:
Last Name:JOZEF
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 VANDERVENTER AVENUE
Mailing Address - Street 2:SUITE #L3C
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-3737
Mailing Address - Country:US
Mailing Address - Phone:516-944-7700
Mailing Address - Fax:516-944-5249
Practice Address - Street 1:14 VANDERVENTER AVENUE
Practice Address - Street 2:SUITE #L3C
Practice Address - City:PORT WASHINGTON
Practice Address - State:NY
Practice Address - Zip Code:11050-3737
Practice Address - Country:US
Practice Address - Phone:516-944-7700
Practice Address - Fax:516-944-5249
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0046551111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYCO46559OtherWORKERS COMP NEW YORK ST
NYX27781Medicare ID - Type Unspecified
NYCO46559OtherWORKERS COMP NEW YORK ST