Provider Demographics
NPI:1851720643
Name:KOSMOSKI, THOMAS BRIAN (PTA)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:BRIAN
Last Name:KOSMOSKI
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 WAYNE AVE
Mailing Address - Street 2:
Mailing Address - City:WEST READING
Mailing Address - State:PA
Mailing Address - Zip Code:19611-1409
Mailing Address - Country:US
Mailing Address - Phone:610-301-1850
Mailing Address - Fax:
Practice Address - Street 1:220 S 4TH AVE
Practice Address - Street 2:
Practice Address - City:WEST READING
Practice Address - State:PA
Practice Address - Zip Code:19611-1350
Practice Address - Country:US
Practice Address - Phone:610-301-1850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-02
Last Update Date:2013-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATEI000692225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant