Provider Demographics
NPI:1942224902
Name:COSGRIFF, JO-ANNE A (MD)
Entity Type:Individual
Prefix:
First Name:JO-ANNE
Middle Name:A
Last Name:COSGRIFF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JO-ANNE
Other - Middle Name:L
Other - Last Name:ALISSI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1625 STRAITS TPKE
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06762-1836
Mailing Address - Country:US
Mailing Address - Phone:203-573-9512
Mailing Address - Fax:203-568-2904
Practice Address - Street 1:590 MIDDLEBURY RD
Practice Address - Street 2:
Practice Address - City:MIDDLEBURY
Practice Address - State:CT
Practice Address - Zip Code:06762-2554
Practice Address - Country:US
Practice Address - Phone:203-758-1004
Practice Address - Fax:203-758-1551
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT042833207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I30977Medicare UPIN