Provider Demographics
NPI:1225441892
Name:KOZA, PAUL
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:KOZA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4155 EWALT RD
Mailing Address - Street 2:
Mailing Address - City:GIBSONIA
Mailing Address - State:PA
Mailing Address - Zip Code:15044-7513
Mailing Address - Country:US
Mailing Address - Phone:724-449-8080
Mailing Address - Fax:
Practice Address - Street 1:4155 EWALT RD
Practice Address - Street 2:
Practice Address - City:GIBSONIA
Practice Address - State:PA
Practice Address - Zip Code:15044-7513
Practice Address - Country:US
Practice Address - Phone:724-449-8080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-11
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP448118183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist