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Individual

DR. JOSEPH WAYNE KOZACHEK

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
441 GURLEYVILLE RD, STORRS, CT 06268-1415
(860) 429-6245
Mailing address
441 GURLEYVILLE RD, STORRS, CT 06268-1415
(860) 429-6245

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
024719
CT

Other

Enumeration date
07/01/2005
Last updated
07/08/2007
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