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NPI Code Detail

MEDICARE: MR. JOSEPH COSENTINO JR. CRNA

MEDICARE:  MR. JOSEPH  COSENTINO JR. CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN142849GA
2163W00000XRegistered Nurse249887NC

General Provider Information

NPI Number : 1205828829
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOSEPH COSENTINO JR. CRNA
Provider Business Mailing Address
First Line : 6632 LOWER BURNINGTOWN RD
Second Line :
City : FRANKLIN
State : NC
Zip : 28734-6482
Country : US
Telephone Number : 828-349-9662
Fax Number :
Provider Business Practice Location Address
First Line : 100 BREWSTER BLVD
Second Line : NAVAL HOSPITAL CAMP LEJEUNE
City : CAMP LEJEUNE
State : NC
Zip : 28547-2538
Country : US
Telephone Number : 828-421-3636
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2005
Last Update Date : 11/02/2011

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Directions to “ MR. JOSEPH COSENTINO JR. CRNA” Practice Location

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