Individual
SHANNON KOZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3300 DEWEY AVE, ROCHESTER, NY 14616-3741
(585) 865-1550
Mailing address
176 RYE RD, ROCHESTER, NY 14626-3659
(585) 507-8940
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
711501
NY
Other
Enumeration date
03/08/2024
Last updated
03/08/2024
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