Provider Demographics
NPI:1881903169
Name:MOSINSKI, NICOLETTE CONCETTA (PA-C, MPAS)
Entity type:Individual
Prefix:
First Name:NICOLETTE
Middle Name:CONCETTA
Last Name:MOSINSKI
Suffix:
Gender:F
Credentials:PA-C, MPAS
Other - Prefix:
Other - First Name:NICOLETTE
Other - Middle Name:CONCETTA
Other - Last Name:CRITELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2187 EDGERTON RD
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-3001
Mailing Address - Country:US
Mailing Address - Phone:716-861-7374
Mailing Address - Fax:
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:800-223-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-04
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5165363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant