Provider Demographics
NPI:1558344085
Name:COSGROVE, CHRISTOPHER JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:JOSEPH
Last Name:COSGROVE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 WATERMAN AVE
Mailing Address - Street 2:
Mailing Address - City:EAST PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02914
Mailing Address - Country:US
Mailing Address - Phone:401-438-5950
Mailing Address - Fax:401-435-2561
Practice Address - Street 1:318 WATERMAN AVE
Practice Address - Street 2:
Practice Address - City:EAST PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02914
Practice Address - Country:US
Practice Address - Phone:401-438-5950
Practice Address - Fax:401-435-2561
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA213611207RN0300X
RI10940207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110007969AMedicaid
3100312OtherUNITED
420927-002OtherCIGNA
MAJ25095OtherBLUE CROSS
390008342OtherRAILROAD MEDICARE
RI1354076OtherAETNA
RI7009941Medicaid
RI10941OtherBLUE CROSS
10318OtherHARVARD PILGRIM
27913OtherNEIGHBORHOOD
RI409631OtherBLUE CHIP
010940OtherTOFTS
420927-002OtherCIGNA
RI1354076OtherAETNA
RI7009941Medicaid