Kevin William Kozlik

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

RT007149 Issued in PA

Practice address

100 Presidential Blvd
Bala Cynwyd, PA 19004-1108

Phone

(610) 668-0904

NPI assigned

Sep 2, 2017

Last updated

May 24, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1504310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1295253888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 HOLLY TREE LN",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087532514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PRESIDENTIAL BLVD",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041108",
            "telephone_number": "610-668-0904"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4200 5th Ave",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152600001",
            "country_code": "US",
            "telephone_number": "412-624-4141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOZLIK",
        "first_name": "KEVIN",
        "middle_name": "WILLIAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-02",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RT007149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John P Kohler, MD
• Amanda M Kopetsky
• Wilhelmina Cornelia Korevaar, MD
• Jordan Kowet
• Michael Paul Kowitt, PHD
• Alan David Krausz, DMD
• Joanna Ku, D.M.D.
• Elizabeth N. Kuh, MD
• Ravi Jonnalagadda Kumar, MBBS
• Nicole Kwak, AUD

• Athletic Trainer in Bala Cynwyd, PA
• Providers in Bala Cynwyd, PA by specialty
• Athletic Trainer in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.