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Individual

TARAS KOZAK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
51 WATERFRONT DR, BALDWINSVILLE, NY 13027-2100
(315) 679-7453
Mailing address
51 WATERFRONT DR, BALDWINSVILLE, NY 13027-2100

Taxonomy

Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
783042
NY

Other

Enumeration date
11/18/2021
Last updated
11/18/2021
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