Healthcare Provider Details

I. General information

NPI: 1730875733
Provider Name (Legal Business Name): ARIANNA L KOSAKOWSKI OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2023
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 MASSACHUSETTS AVE
LUNENBURG MA
01462-1218
US

IV. Provider business mailing address

31 MINUTEMAN DR
TEMPLETON MA
01468-1576
US

V. Phone/Fax

Practice location:
  • Phone: 978-660-7115
  • Fax:
Mailing address:
  • Phone: 978-660-7115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number5612
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: