Provider Demographics
NPI:1750309241
Name:J & E MEDICAL SPECIALTIES, PC
Entity Type:Organization
Organization Name:J & E MEDICAL SPECIALTIES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FELIXBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:COSICO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-672-6673
Mailing Address - Street 1:50 BRIGHAM RD
Mailing Address - Street 2:
Mailing Address - City:FREDONIA
Mailing Address - State:NY
Mailing Address - Zip Code:14063-1004
Mailing Address - Country:US
Mailing Address - Phone:716-672-6662
Mailing Address - Fax:
Practice Address - Street 1:50 BRIGHAM RD
Practice Address - Street 2:
Practice Address - City:FREDONIA
Practice Address - State:NY
Practice Address - Zip Code:14063-1004
Practice Address - Country:US
Practice Address - Phone:716-672-6662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY239319207RC0200X, 207RP1001X
NY239552208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
Not Answered207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02662802Medicaid
NYH52935Medicare UPIN
NY02662802Medicaid