Basic Information
Provider Information
NPI: 1144306085
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KOJAOGHLANIAN
FirstName: TSOLINE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
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Mailing Information
Address1: 4422 3RD AVE
Address2: MILLS BLDG, 4TH FLOOR
City: BRONX
State: NY
PostalCode: 104572545
CountryCode: US
TelephoneNumber: 7189609331
FaxNumber: 7189603792
Practice Location
Address1: 4422 3RD AVE
Address2: MILLS BLDG, 4TH FLOOR
City: BRONX
State: NY
PostalCode: 104572545
CountryCode: US
TelephoneNumber: 7189609331
FaxNumber: 7189603792
Other Information
ProviderEnumerationDate: 10/31/2006
LastUpdateDate: 02/27/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2080P0208X269020NYY Allopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases

No ID Information.


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