Provider Demographics
NPI:1760400709
Name:COSSI, ALDA FELICITA (MD)
Entity Type:Individual
Prefix:
First Name:ALDA
Middle Name:FELICITA
Last Name:COSSI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-1445
Mailing Address - Country:US
Mailing Address - Phone:781-879-9371
Mailing Address - Fax:
Practice Address - Street 1:29 DRAPER ST
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-4570
Practice Address - Country:US
Practice Address - Phone:781-879-9371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA605502085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110053371AMedicaid
MA300044067OtherRR MEDICARE
MAKX1027Medicare PIN
MA300044067OtherRR MEDICARE
MAB20413301-446OtherCIGNA
MA4395432OtherA/US NON-HMO
MAJ14111Medicare ID - Type Unspecified
MA16-01464OtherEVERCARE
MA734635OtherSECURE
MA754664OtherFIRST
MA248997OtherPHCS
MA734635OtherTUFTS
MA01Y000369MA01OtherANTHEM03
MA3776985OtherCIGNAPAL-S
MAJ14111OtherHMO BLUE
MAJ14111OtherBC65
F62824Medicare UPIN
MA042704683010OtherHEALTHNET / TRICARE
MAF62824LCOtherHPHC
MA110053371AMedicaid