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NPI Code Detail

MEDICARE: LAURA C KOZOL PA-C

MEDICARE: LAURA C KOZOL PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant9108403FL
2363A00000XPhysician AssistantPA3809MA
3363A00000XPhysician Assistant3237CT

General Provider Information

NPI Number : 1548593643
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA C KOZOL PA-C
Provider Business Mailing Address
First Line : 80 SEYMOUR ST
Second Line :
City : HARTFORD
State : CT
Zip : 06106-3300
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 80 SEYMOUR ST
Second Line :
City : HARTFORD
State : CT
Zip : 06106-3300
Country : US
Telephone Number : 860-972-2795
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2009
Last Update Date : 01/26/2022

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Directions to “ LAURA C KOZOL PA-C” Practice Location

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