Provider Demographics
NPI:1972029544
Name:COSGROVE, ANNA COUGHLIN (AUD)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:COUGHLIN
Last Name:COSGROVE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 HACKETT BLVD FL 1
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3420
Mailing Address - Country:US
Mailing Address - Phone:518-262-4535
Mailing Address - Fax:
Practice Address - Street 1:35 HACKETT BLVD FL 1
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3420
Practice Address - Country:US
Practice Address - Phone:518-262-4535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-16
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4706231H00000X
231H00000X
NY14000069400231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist