Provider Demographics
NPI:1154331833
Name:MICHAEL R. COZZA, JR. M.D.
Entity Type:Organization
Organization Name:MICHAEL R. COZZA, JR. M.D.
Other - Org Name:BEAVER VALLEY REHABILITATION ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANTOINETTE
Authorized Official - Middle Name:M
Authorized Official - Last Name:COZZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-728-2050
Mailing Address - Street 1:1360 SHARON ROAD
Mailing Address - Street 2:
Mailing Address - City:BEAVER
Mailing Address - State:PA
Mailing Address - Zip Code:15009-3128
Mailing Address - Country:US
Mailing Address - Phone:724-775-6220
Mailing Address - Fax:724-775-6438
Practice Address - Street 1:1360 SHARON ROAD
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-3128
Practice Address - Country:US
Practice Address - Phone:724-775-6220
Practice Address - Fax:724-775-6438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000103587Medicare ID - Type UnspecifiedBEAVER VALLEY REHAB ASSOC