Provider Demographics
NPI:1346852332
Name:COSNER, LUIS V
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:V
Last Name:COSNER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:343 MT LAKE RD
Mailing Address - Street 2:
Mailing Address - City:HEDGESVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25427
Mailing Address - Country:US
Mailing Address - Phone:304-754-9565
Mailing Address - Fax:
Practice Address - Street 1:343 MT LAKE RD
Practice Address - Street 2:
Practice Address - City:HEDGESVILLE
Practice Address - State:WV
Practice Address - Zip Code:25427
Practice Address - Country:US
Practice Address - Phone:304-754-9565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-20
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant