Provider Demographics
NPI:1639230840
Name:COZZARELLI-FRANKLIN, ANNETTE O (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNETTE
Middle Name:O
Last Name:COZZARELLI-FRANKLIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:175 FRANKLIN AVE
Mailing Address - Street 2:STE 201
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-3819
Mailing Address - Country:US
Mailing Address - Phone:973-667-8535
Mailing Address - Fax:973-667-8442
Practice Address - Street 1:175 FRANKLIN AVE
Practice Address - Street 2:STE 201
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-3819
Practice Address - Country:US
Practice Address - Phone:973-667-8535
Practice Address - Fax:973-667-8442
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA58096207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8650403Medicaid
NJF36083Medicare UPIN
NJ8650403Medicaid