MEDICARE: MRS. CYNTHIA ANN MCOSKER MA MED CCC-SLP

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
1	235Z00000X	Speech-Language Pathologist	SP 290	ME

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	060221	OTHER	ME	ANTHEM
2	7435486	OTHER	ME	AETNA

General Provider Information

NPI Number	:	1215127915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CYNTHIA ANN MCOSKER MA MED CCC-SLP

Provider Business Mailing Address
First Line	:	140 SCAMMAN ST
Second Line	:
City	:	SOUTH PORTLAND
State	:	ME
Zip	:	04106-4536
Country	:	US
Telephone Number	:	207-799-9145
Fax Number	:

Provider Business Practice Location Address
First Line	:	140 SCAMMAN ST
Second Line	:
City	:	SOUTH PORTLAND
State	:	ME
Zip	:	04106-4536
Country	:	US
Telephone Number	:	207-799-9145
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2007
Last Update Date	:	07/28/2007

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Directions to “ MRS. CYNTHIA ANN MCOSKER MA MED CCC-SLP” Practice Location

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