Doctor Name: | JOANN KOSIK |
NPI Number: | 1295848646 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MHA, PA-C |
License Number: | OA000366L |
Business Practice Address: | 824 Mcalpine St Avoca, PA - 186411140 |
Business Phone Number: | 5704579299 |
Business Fax Number: | 5704575014 |
Mailing Address: | 824 Mcalpine St, AVOCA |
State: | PA |
Postal Code: | 186411140 |
Phone Number: | 5704579299 |
Fax Number: | 5704575014 |
NPI Enumeration Date: | 08/17/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | OA000366L |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |