Provider Demographics
NPI:1508243288
Name:KOSYAK CONSULTING
Entity Type:Organization
Organization Name:KOSYAK CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:TATIANA
Authorized Official - Middle Name:E
Authorized Official - Last Name:KOSYAK
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:386-235-8760
Mailing Address - Street 1:38 LAUREL RIDGE BREAK
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174
Mailing Address - Country:US
Mailing Address - Phone:386-235-8760
Mailing Address - Fax:
Practice Address - Street 1:63 SADDLERS RUN
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-2456
Practice Address - Country:US
Practice Address - Phone:386-481-3886
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-01
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS213641835P0018X
CO116671835P0018X
IL051.0368831835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistGroup - Multi-Specialty