Provider Demographics
NPI:1194140210
Name:KOCYLOWSKY, XENYA EVE (OD)
Entity type:Individual
Prefix:DR
First Name:XENYA
Middle Name:EVE
Last Name:KOCYLOWSKY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 14TH ST NW
Mailing Address - Street 2:UNIT B
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-4430
Mailing Address - Country:US
Mailing Address - Phone:202-644-7500
Mailing Address - Fax:
Practice Address - Street 1:1919 14TH ST NW
Practice Address - Street 2:UNIT B
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-4430
Practice Address - Country:US
Practice Address - Phone:202-644-7500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-26
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCOP1000218152W00000X
VA0618001999152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCOP1000218OtherSTATE