Provider Demographics
NPI:1457061004
Name:COSME, LESLIE ANN (RN)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:ANN
Last Name:COSME
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 W HILL DR UNIT D
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01473-1142
Mailing Address - Country:US
Mailing Address - Phone:978-855-1905
Mailing Address - Fax:
Practice Address - Street 1:175 CONNORS ST STE 1
Practice Address - Street 2:
Practice Address - City:GARDNER
Practice Address - State:MA
Practice Address - Zip Code:01440-2637
Practice Address - Country:US
Practice Address - Phone:978-410-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN232065163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse