Provider Demographics
NPI:1982612776
Name:COSICO, LIGAYA P (MD)
Entity Type:Individual
Prefix:DR
First Name:LIGAYA
Middle Name:P
Last Name:COSICO
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 1:700 MCCLELLAN ST
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12304-1019
Mailing Address - Country:US
Mailing Address - Phone:518-372-5637
Mailing Address - Fax:518-372-1384
Practice Address - Street 1:700 MCCLELLAN ST
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12304-1019
Practice Address - Country:US
Practice Address - Phone:518-372-5637
Practice Address - Fax:518-372-1384
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY117402208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY070119000086OtherFIDELIS
NY26101OtherMVP
NY47326OtherGHI/HMO
NY000401221001OtherBSNENY
NY00543348Medicaid
NY545151OtherEMPIRE BC
NY10000402OtherCDPHP
NY200088OtherSENIOR WHOLE HEALTH
NY4475231OtherAETNA