Provider Demographics
NPI:1457675217
Name:KOSINSKI, BERNADETTE ANNMARIE
Entity Type:Individual
Prefix:
First Name:BERNADETTE
Middle Name:ANNMARIE
Last Name:KOSINSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 ELDER DR
Mailing Address - Street 2:
Mailing Address - City:MASTIC BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11951-4603
Mailing Address - Country:US
Mailing Address - Phone:631-773-4003
Mailing Address - Fax:
Practice Address - Street 1:130 ELDER DR
Practice Address - Street 2:
Practice Address - City:MASTIC BEACH
Practice Address - State:NY
Practice Address - Zip Code:11951-4603
Practice Address - Country:US
Practice Address - Phone:631-772-4003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-23
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion