Provider Demographics
NPI:1467996207
Name:COSGROVE, JOHN (ATC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:COSGROVE
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:622 W 168TH ST
Mailing Address - Street 2:PRESBYTERIAN HOSPITAL, 11TH FLOOR- CENTER WING
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3720
Mailing Address - Country:US
Mailing Address - Phone:646-317-5162
Mailing Address - Fax:212-305-4040
Practice Address - Street 1:622 W 168TH ST
Practice Address - Street 2:PRESBYTERIAN HOSPITAL, 11TH FLOOR- CENTER WING
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3720
Practice Address - Country:US
Practice Address - Phone:646-317-5162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-13
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2000017672246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2000017672OtherATC