Elissa Kate Kozlov, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

022411 Issued in NY

Practice address

1745 Broadway FL 17
New York, NY 10019-4642

Phone

(212) 851-8100

Fax

(212) 537-0102

NPI assigned

Dec 3, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective May 23, 2022 through May 23, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1512259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1518472398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 E 75TH ST",
            "address_2": "2H",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100213314",
            "telephone_number": "914-715-3012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1745 BROADWAY FL 17",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100194642",
            "telephone_number": "212-851-8100",
            "fax_number": "212-537-0102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1339 York Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100214707",
            "country_code": "US",
            "telephone_number": "212-628-2800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOZLOV",
        "first_name": "ELISSA",
        "middle_name": "KATE",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-03",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "NY",
            "license": "022411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ewa Kozikowska, MD
• Adam Kozikowski, NP
• Allen C Kozin
• Klaudia Koziol
• Ewa Irena Koziorynska, M.D.
• Chaim Kozlovsky, PA-C
• Joanna Kozlovsky
• Rachel Kozlowski, PSY.D.
• Rachel M Kozlowsky
• Peter S Kozuch, MD

• Psychologist in New York, NY
• Providers in New York, NY by specialty
• Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.