Provider Demographics
NPI:1891439840
Name:KOCSIK, ALEXANDRA (MD)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:KOCSIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1926 N 2ND ST APT 3
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19122-2323
Mailing Address - Country:US
Mailing Address - Phone:508-404-9225
Mailing Address - Fax:
Practice Address - Street 1:2094 PITKIN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-3509
Practice Address - Country:US
Practice Address - Phone:844-692-4692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-26
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD485831207Q00000X
NY337890207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine