Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 166 | NH |
Y | 222Z00000X | Podiatrist | 166 | NH |
NPI | 1053397125 |
---|---|
Provider Name | Dr. David R. Kosofsky |
First Address | Nashua, NH 03060-3676 |
Second Address | Nashua, NH 03060-3676 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2005 |
Last Update Date | 03/02/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0308265Y0NH02 | ANTHEM BLUE CROSS BLUE SHIELD (01) | NH |
30364153 | (05) | NH |
DC3586 | PALMETTO GBA RAILROAD MEDICARE (01) | NH |
T25736 | (02) | NH |