Provider Demographics
NPI:1053577007
Name:KOZLOVSKY, ADRIANE STEIN (MS, RD, LD)
Entity type:Individual
Prefix:MRS
First Name:ADRIANE
Middle Name:STEIN
Last Name:KOZLOVSKY
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 LEE CT
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-4402
Mailing Address - Country:US
Mailing Address - Phone:443-804-8996
Mailing Address - Fax:
Practice Address - Street 1:3301 LEE CT
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21208-4402
Practice Address - Country:US
Practice Address - Phone:443-804-8996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-30
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00264133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDF625OtherCAREFIRST BLUE CHOICE
MD04NUASOtherCAREFIRST BLUE CROSS BLUE SHIELD