Provider Demographics
NPI:1629508833
Name:COSENTINO, MARIA ROSE (DPM)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ROSE
Last Name:COSENTINO
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 AMHERST AVE
Mailing Address - Street 2:STE B
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66503-3050
Mailing Address - Country:US
Mailing Address - Phone:316-461-0532
Mailing Address - Fax:785-330-2066
Practice Address - Street 1:2900 AMHERST AVE
Practice Address - Street 2:STE B
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66503-3050
Practice Address - Country:US
Practice Address - Phone:316-461-0532
Practice Address - Fax:785-360-2066
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-20
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY390200000X
KS12-00458213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty