Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | DC088762 | PA |
N | 111NI0900X | Internist | DC088762 | PA |
N | 111NN0400X | Neurology | DC008762 | PA |
N | 111NR0200X | Radiology | DC008762 | PA |
N | 213ER0200X | Radiology | DC008762 | PA |
Y | 111NR0400X | Rehabilitation Chiropractor | DC008762 | PA |
N | 111NS0005X | Chiropractic Sports Physician | DC008762 | PA |
N | 111NT0100X | Thermography | DC008762 | PA |
N | 111NX0100X | Occupational Health | DC008762 | PA |
N | 111NX0800X | Chiropractor Orthopedic Specialist | DC008762 | PA |
NPI | 1467576546 |
---|---|
Provider Name | Tisha A. Cozart |
First Address | Galloway, NJ 08205-4464 |
Second Address | Galloway, NJ 08205-4464 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2007 |
Last Update Date | 29/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
055089WZ9 | MEDICARE (01) | PA |
1030414 | HEALTH ASSURANCE (01) | PA |
1354319 | BLUE CROSS (01) | PA |
6235788-001 | CIGNA (01) | PA |