Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 11023 | AK |
Y | 111NI0900X | Internist | 11023 | AK |
N | 208D00000X | General Practice Physician | 0102203678 | VA |
NPI | 1013276898 |
---|---|
Provider Name | Dr. Nicholas Paul Cosentino |
First Address | Anchorage, AK 99506-3702 |
Second Address | Fairbanks, AK 99701 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2012 |
Last Update Date | 18/06/2019 |