MARK EDWARD KOZMINSKY (NPI# 1861482788) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861482788 |
| Entity Type | Individual |
| Full Name | MARK EDWARD KOZMINSKY |
| Credential | M.D. |
| Practice Address |
2505 Green Tech Dr Suite A1 State College PA 16803-2316 |
| Mailing Address |
113 Wildernest Ln Port Matilda PA 16870-7107 |
| Practice Telephone | 8142376600 |
| Practice Fax Number | 8142375383 |
| Mailing Telephone | 8142376524 |
| Enumeration Date | 2005-10-22 |
| Last Update Date | 2013-12-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | MD033463E | PA | Allopathic & Osteopathic Physicians |
| Street Address |
2505 GREEN TECH DR SUITE A1 |
| City | STATE COLLEGE |
| State | PA |
| Zip Code | 16803-2316 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356584841 | Scott Michael Dehart | Preventive Medicine | 2505 Green Tech Dr, Suite C, State College, PA 16803-2316 | 2009-04-13 |
| 1487861324 | John Roberts Enterprises Inc | Durable Medical Equipment & Medical Supplies | 2505 Green Tech Dr, Suite A2, State College, PA 16803-2316 | 2007-05-17 |
| 1114052750 | Centre Health Network, LLC | Preventive Medicine | 2505 Green Tech Dr, Ste. C, State College, PA 16803-2316 | 2007-02-23 |
| 1568488500 | Yi H Kao | Otolaryngology | 2505 Green Tech Dr, Suite C, State College, PA 16803-2316 | 2006-07-14 |
| 1558394908 | Otolaryngology Group of Central Pennsylvania | Otolaryngology | 2505 Green Tech Dr, Suite C, State College, PA 16803-2316 | 2006-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346851581 | Tammy Lynn Terosky | Massage Therapist | 2134 Sandy Drive, Suite 6, State College, PA 16803 | 2020-08-12 |
| 1548748973 | Molly Gomez | Occupational Therapist | 260 Lions Hill Road, State College, PA 16803 | 2018-07-28 |
| 1568981827 | David Scott Kautz | Pharmacist | 1665 North Atherton Place, State College, PA 16803 | 2017-09-18 |
| 1245751023 | Zenovia Tarmohamed | Student in an Organized Health Care Education/Training Program | 1850 East Park Avenue, Suite 207, Penn State Health At Mount Nittany Medical Center, State College, PA 16803 | 2017-06-30 |
| 1407205362 | Alka Sood | Student in an Organized Health Care Education/Training Program | 1850 E. Park Avenue, State College, PA 16803 | 2016-06-10 |
| 1588018766 | Daniel Frankel | Student in an Organized Health Care Education/Training Program | 1850 East Park Avenue, Suite 207, State College, PA 16803 | 2016-04-14 |
| 1154791903 | Megan Widener | Physician Assistant | 2520 Green Tech Dr., Ste. D, State College, PA 16803 | 2015-10-05 |
| 1114301330 | Phuong Tran Courtney | Physician Assistant | 1613 North Atherton Street, Suite B, State College, PA 16803 | 2015-07-17 |
| 1164806840 | Amit Thatte | Student in an Organized Health Care Education/Training Program | 1850 East Park Ave., Suite 207, Penn State Hershey Medical Group, State College, PA 16803 | 2015-07-13 |
| 1245588946 | Phoenix Rehabilitation and Health Services, Inc. | Chiropractor | 1700 Old Gatesburg Road, Suite 210, State College, PA 16803 | 2012-08-28 |
| Find all providers in zip 16803 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235224957 | Dermatology Assoc of Central Pa, PC | Dermatology | 1393 N Atherton St, State College, PA 16803-2932 | 2006-10-04 |
| 1811973894 | Mary Amanda Jacobs | Dermatology | 200 Scenery Dr., State College, PA 16801-5602 | 2005-12-21 |
| 1992781959 | Sara B Ferguson | Dermatology | 32 Colonnade Way, State College, PA 16803-2309 | 2005-12-21 |
| 1972020766 | Milton S Hershey Medical Center Physicians Group | Dermatology | 1850 E Park Ave Ste 207, State College, PA 16803-6706 | 2017-08-23 |
| 1841677424 | Jennifer Leigh Brooks | Dermatology | 200 Scenery Dr, State College, PA 16801-7974 | 2015-05-02 |
| 1508203811 | Cassandra Joy Simonetta | Dermatology | 32 Colonnade Way, State College, PA 16803 | 2013-05-28 |
| 1205095486 | Nicole F Velez | Dermatology | 200 Scenery Dr, State College, PA 16801-7974 | 2008-06-03 |
| 1902015597 | Matthew Allyn Hazey | Dermatology | 1850 E Park Ave Ste 312, State College, PA 16803 | 2007-05-21 |
| 1770797953 | Lorraine Rosamilia | Dermatology | 200 Scenery Dr, State College, PA 16801-7974 | 2007-05-09 |
| 1073727251 | Stacy Klepeiss | Dermatology | 200 Scenery Dr, State College, PA 16801-7974 | 2007-05-09 |
| Find all providers in STATE COLLEGE | ||||
| City | STATE COLLEGE |
| Zip Code | 16803 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.