Provider Demographics
NPI:1932426087
Name:KOZINA, JOAN (RN)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:
Last Name:KOZINA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1384 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14212-1808
Mailing Address - Country:US
Mailing Address - Phone:716-894-9672
Mailing Address - Fax:716-894-9676
Practice Address - Street 1:1384 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14212-1808
Practice Address - Country:US
Practice Address - Phone:716-894-9672
Practice Address - Fax:716-894-9676
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-29
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2368501163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health