Provider Demographics
NPI:1689152837
Name:KOSOFF, HADASSAH (RN)
Entity Type:Individual
Prefix:
First Name:HADASSAH
Middle Name:
Last Name:KOSOFF
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1438 BAY 28TH ST
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-1704
Mailing Address - Country:US
Mailing Address - Phone:718-327-6653
Mailing Address - Fax:
Practice Address - Street 1:1438 BAY 28TH ST
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-1704
Practice Address - Country:US
Practice Address - Phone:718-327-6653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-31
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7463741163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse