Provider Demographics
NPI:1467941849
Name:KOSAR, RACHAEL MARIE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:RACHAEL
Middle Name:MARIE
Last Name:KOSAR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:RACHAEL
Other - Middle Name:M
Other - Last Name:NASCA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:ELM AND CARLTON ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14263-0001
Mailing Address - Country:US
Mailing Address - Phone:716-845-2300
Mailing Address - Fax:716-845-8812
Practice Address - Street 1:ELM AND CARLTON ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14263-0001
Practice Address - Country:US
Practice Address - Phone:716-845-2300
Practice Address - Fax:716-845-8812
Is Sole Proprietor?:No
Enumeration Date:2018-05-01
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9111138363A00000X
PAOA004906363A00000X
NY024881363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant