Healthcare Provider Details

I. General information

NPI: 1346120284
Provider Name (Legal Business Name): DR. NEIL STEVEN COSSIN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2025
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

RAVINA 16 , APARTMENT 1
RAMAT BET SHEMESH DALET,9920417 JERUSALEM
9920417
IL

IV. Provider business mailing address

RAVINA 16 , APARTMENT 1
RAMAT BET SHEMESH DALET,9920417 JERUSALEM
9920417
IL

V. Phone/Fax

Practice location:
  • Phone:
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number23933
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: