Active NPI
Mary Ann Koza, D.O.
- Psychiatry Physician
- Allentown, PA
National Provider Identifier
1114123288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- OS015258
- Practice address
- 1605 N Cedar Crest Blvd
Allentown, PA 18104-2351 - Phone
- (610) 841-4144
- NPI assigned
- Jun 25, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | OS015258 | PA | Primary |
Addresses
Primary practice location
1605 N Cedar Crest Blvd
Allentown, PA 18104-2351
Mailing address
PO Box 505
Wilkes Barre, PA 18703-0505
Phone (570) 690-1778
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS015258 | PA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1482451200000",
"number": "1114123288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 505",
"city": "WILKES BARRE",
"state": "PA",
"postal_code": "187030505",
"telephone_number": "570-690-1778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1605 N CEDAR CREST BLVD",
"city": "ALLENTOWN",
"state": "PA",
"postal_code": "181042351",
"telephone_number": "610-841-4144"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOZA",
"first_name": "MARY ANN",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-25",
"last_updated": "2016-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "PA",
"license": "OS015258",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Allentown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.