Healthcare Provider Details

I. General information

NPI: 1851957666
Provider Name (Legal Business Name): JENNIFER COSKUN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2019
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13065 W MCDOWELL RD STE C130
AVONDALE AZ
85392-6448
US

IV. Provider business mailing address

8901 WISCONSIN AVE
BETHESDA MD
20899
US

V. Phone/Fax

Practice location:
  • Phone: 623-846-7575
  • Fax: 623-846-3778
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number012443
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2296
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: