Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 253281 | NY |
N | 207XS0117X | Orthopaedic Spine Surgeon | 0101259474 | VA |
N | 207XS0117X | Orthopaedic Spine Surgeon | 46398 | KY |
NPI | 1386840411 |
---|---|
Provider Name | Mark Peter Coseo |
First Address | Portsmouth, VA 23708-2111 |
Second Address | Portsmouth, VA 23708-2111 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2007 |
Last Update Date | 11/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
253281 | NY LICENSE (01) | NY |
7100304270 | (05) | KY |