MEDICARE: EDIZ F. COSAR MD

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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	222585	MA

General Provider Information

NPI Number	:	1467442798
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDIZ F. COSAR MD

Provider Business Mailing Address
First Line	:	280 CHESTNUT STREET, 2ND FLOOR
Second Line	:
City	:	SPRINGFIELD
State	:	MA
Zip	:	01199-1001
Country	:	US
Telephone Number	:	413-794-5700
Fax Number	:

Provider Business Practice Location Address
First Line	:	759 CHESTNUT STREET
Second Line	:	D1170
City	:	SPRINGFIELD
State	:	MA
Zip	:	01107-1619
Country	:	US
Telephone Number	:	413-794-4550
Fax Number	:	413-794-3195

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

Provider Enumeration Date	:	10/27/2005
Last Update Date	:	09/27/2021

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