Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 34006288 | OH |
N | 207YS0123X | Facial Plastic Surgeon | 34006288 | OH |
NPI | 1356323000 |
---|---|
Provider Name | Mathew J Cosenza |
First Address | Gallipolis, OH 45631-1560 |
Second Address | Jackson, OH 45640-9452 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2005 |
Last Update Date | 21/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000260440 | ANTHEM BLUE CROSS (01) | OH |
2211949 | (05) | OH |
2211949 | RAILROAD MEDICARE (01) | OH |
7664166 | AETNA (01) | |
8949866 | CIGNA (01) | |
H26892 | (02) |