Provider Demographics
NPI:1497783468
Name:KOSIK, JAMES J (DO)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:J
Last Name:KOSIK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:824 MCALPINE ST
Mailing Address - Street 2:
Mailing Address - City:AVOCA
Mailing Address - State:PA
Mailing Address - Zip Code:18641-1140
Mailing Address - Country:US
Mailing Address - Phone:570-457-9299
Mailing Address - Fax:570-457-5014
Practice Address - Street 1:824 MCALPINE ST
Practice Address - Street 2:
Practice Address - City:AVOCA
Practice Address - State:PA
Practice Address - Zip Code:18641-1140
Practice Address - Country:US
Practice Address - Phone:570-457-9299
Practice Address - Fax:570-457-5014
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS007465-L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine