Provider Demographics
NPI:1982856985
Name:KOSICA HEALTH SERVICES
Entity Type:Organization
Organization Name:KOSICA HEALTH SERVICES
Other - Org Name:N/A
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:O
Authorized Official - Last Name:ANIEKWE
Authorized Official - Suffix:
Authorized Official - Credentials:RN,BSN,BSECON
Authorized Official - Phone:718-715-4246
Mailing Address - Street 1:8966 211TH ST
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11427-2308
Mailing Address - Country:US
Mailing Address - Phone:718-715-4246
Mailing Address - Fax:718-715-4246
Practice Address - Street 1:8966 211TH ST
Practice Address - Street 2:
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11427-2308
Practice Address - Country:US
Practice Address - Phone:718-715-4246
Practice Address - Fax:718-715-4246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency