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Individual

SHIRELY KOCZAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1 DEACONESS RD, BOSTON, MA 02215-5321
(617) 754-3150
Mailing address
148 SYCAMORE ST, SOMERVILLE, MA 02145-2745

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN117059
MA

Other

Enumeration date
10/14/2010
Last updated
10/14/2010
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