Provider Demographics
NPI:1376681585
Name:DRS KOSUNICK & SCOTT INC
Entity Type:Organization
Organization Name:DRS KOSUNICK & SCOTT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:KOSUNICK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:440-263-6227
Mailing Address - Street 1:4786B RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:OH
Mailing Address - Zip Code:44144-3327
Mailing Address - Country:US
Mailing Address - Phone:216-398-1436
Mailing Address - Fax:216-398-2572
Practice Address - Street 1:4786B RIDGE RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:OH
Practice Address - Zip Code:44144-3327
Practice Address - Country:US
Practice Address - Phone:216-398-1436
Practice Address - Fax:216-398-2572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2010-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH5326152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHDR9351312Medicare ID - Type Unspecified