Provider Demographics
NPI:1881747822
Name:KOSINSKI, ERIC C (MD)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:C
Last Name:KOSINSKI
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Gender:M
Credentials:MD
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Mailing Address - Street 1:50 MEMORIAL DR
Mailing Address - Street 2:SUITE 206
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-2238
Mailing Address - Country:US
Mailing Address - Phone:978-840-0400
Mailing Address - Fax:978-840-0404
Practice Address - Street 1:50 MEMORIAL DR
Practice Address - Street 2:SUITE 206
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-2238
Practice Address - Country:US
Practice Address - Phone:978-840-0400
Practice Address - Fax:978-840-0404
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2020-11-29
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Provider Licenses
StateLicense IDTaxonomies
MA2462582084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110088298AMedicaid