Individual
SHEA M KOZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
80 SEYMOUR STREET, HARTFORD HOSPITAL SURGERY DEPT, HARTFORD, CT 06102-8000
(860) 972-5022
Mailing address
80 SEYMOUR STREET, HARTFORD HOSPITAL SURGERY DEPT, HARTFORD, CT 06102-8000
(860) 972-5022
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
4006
CT
363AS0400X
Surgical Physician Assistant
Primary
004006
CT
Other
Enumeration date
11/21/2017
Last updated
08/27/2024
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