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Individual

MS. SHARON S. KOZLOWSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CFNP

Contact information

Practice address
1780 HANSHAW RD, ITHACA, NY 14850-9105
(607) 257-5858
(607) 257-1718
Mailing address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F331175-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01731891
NY
01
500018987
RR MEDICARE PIN
NY
01
CC8362
RR MEDICARE GROUP
NY
Enumeration date
03/20/2006
Last updated
08/02/2011
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