Provider Demographics
NPI:1265046924
Name:KOSINSKI, MEREDITH MARIE (TEACHER)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:MARIE
Last Name:KOSINSKI
Suffix:
Gender:F
Credentials:TEACHER
Other - Prefix:
Other - First Name:MEREDITH
Other - Middle Name:MARIE
Other - Last Name:LANE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:TEACHER
Mailing Address - Street 1:257 SAGAMORE HILLS DR
Mailing Address - Street 2:
Mailing Address - City:PORT JEFFERSON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11776-3530
Mailing Address - Country:US
Mailing Address - Phone:631-645-4975
Mailing Address - Fax:
Practice Address - Street 1:257 SAGAMORE HILLS DR
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON STATION
Practice Address - State:NY
Practice Address - Zip Code:11776-3530
Practice Address - Country:US
Practice Address - Phone:631-645-4975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist