Healthcare Provider Details

I. General information

NPI: 1477985984
Provider Name (Legal Business Name): COSKU TAALU LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2013
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 292
BURLINGTON NJ
08016-0292
US

IV. Provider business mailing address

10 WOODSTONE LN
BURLINGTON NJ
08016-4333
US

V. Phone/Fax

Practice location:
  • Phone: 609-284-2368
  • Fax:
Mailing address:
  • Phone: 609-284-2368
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05578200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: