Provider Demographics
NPI:1033512736
Name:KOSER, TODD (PSYD)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:
Last Name:KOSER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1930 MARLTON PIKE E STE J49
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-4106
Mailing Address - Country:US
Mailing Address - Phone:856-313-5619
Mailing Address - Fax:888-496-4170
Practice Address - Street 1:1930 MARLTON PIKE E STE J49
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-4106
Practice Address - Country:US
Practice Address - Phone:856-313-5619
Practice Address - Fax:888-496-4170
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS017696103TC2200X, 103TM1800X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities