Provider Demographics
NPI:1578669214
Name:COSME-THORMANN, BRAULIO FEDERICO (MD)
Entity Type:Individual
Prefix:DR
First Name:BRAULIO
Middle Name:FEDERICO
Last Name:COSME-THORMANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8563 212TH ST
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11427-1340
Mailing Address - Country:US
Mailing Address - Phone:718-217-8482
Mailing Address - Fax:
Practice Address - Street 1:8211 37TH AVE
Practice Address - Street 2:5TH FLOOR
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-7001
Practice Address - Country:US
Practice Address - Phone:718-899-5900
Practice Address - Fax:718-899-2134
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY255151207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease