Provider Demographics
NPI:1316681539
Name:KOZATO, AKIO (MD)
Entity type:Individual
Prefix:
First Name:AKIO
Middle Name:
Last Name:KOZATO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:AKIKO
Other - Middle Name:MICHELE
Other - Last Name:KOZATO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:323 W 112TH ST APT 3
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10026-3292
Mailing Address - Country:US
Mailing Address - Phone:408-621-8248
Mailing Address - Fax:
Practice Address - Street 1:630 W 168TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3725
Practice Address - Country:US
Practice Address - Phone:408-621-8248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-25
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program