Provider Demographics
NPI:1679230585
Name:COSME, ANTHONY (EMT, MAP, NAR)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:COSME
Suffix:
Gender:M
Credentials:EMT, MAP, NAR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13105 21ST DR SE APT C102
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-7158
Mailing Address - Country:US
Mailing Address - Phone:425-287-9056
Mailing Address - Fax:
Practice Address - Street 1:13020 MERIDIAN AVE S
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-6468
Practice Address - Country:US
Practice Address - Phone:425-357-3900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-26
Last Update Date:2021-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic
No156F00000XEye and Vision Services ProvidersTechnician/Technologist