NPI Profile for SHEA KOZAK in MANCHESTER, CT.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Surgical |
363AS0400X | 97 | Physician Assistant | |
Physician Assistant |
363A00000X | 97 | Physician Assistant |
| NPI Number | 1740794106 |
|
| Status | Active | |
| Credentials | PA-C (Physician Assistant-Certified) | |
| Entity | Individual | |
| Enumeration date | 11/21/2017 | |
| Last updated | 08/27/2024 - More than a year ago | |
| Sole proprietor 1 | No | |
| Identifiers |
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| Hospital affiliation(s) |
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SHEA KOZAK
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