Provider Demographics
NPI:1720758642
Name:KOSSOW & SANDBERG MD LLC
Entity Type:Organization
Organization Name:KOSSOW & SANDBERG MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:LYNNE
Authorized Official - Middle Name:B
Authorized Official - Last Name:KOSSOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-410-5487
Mailing Address - Street 1:731 ALEXANDER RD STE 201
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-6345
Mailing Address - Country:US
Mailing Address - Phone:609-655-3800
Mailing Address - Fax:866-912-7741
Practice Address - Street 1:731 ALEXANDER RD STE 201
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-6345
Practice Address - Country:US
Practice Address - Phone:609-655-3800
Practice Address - Fax:866-912-7741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-14
Last Update Date:2022-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty