Provider Demographics
NPI:1356338552
Name:KOSSOL, JANET M (MD)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:M
Last Name:KOSSOL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 OHIO RIVER BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-1300
Mailing Address - Country:US
Mailing Address - Phone:412-741-6530
Mailing Address - Fax:412-741-9274
Practice Address - Street 1:301 OHIO RIVER BLVD STE 300
Practice Address - Street 2:
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-1300
Practice Address - Country:US
Practice Address - Phone:412-741-6530
Practice Address - Fax:412-741-9274
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD025541E2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001011457Medicaid
B40907Medicare UPIN
PA001011457Medicaid
PA187836H78Medicare Oscar/Certification
PA0009580730001Medicaid