Healthcare Provider Details

I. General information

NPI: 1952716805
Provider Name (Legal Business Name): CYNTHIA A. KOS D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2014
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1945 STATE ROUTE 33
NEPTUNE NJ
07753-4859
US

IV. Provider business mailing address

200 TRENTON RD
BROWNS MILLS NJ
08015-1705
US

V. Phone/Fax

Practice location:
  • Phone: 732-776-2330
  • Fax: 732-776-2344
Mailing address:
  • Phone: 609-893-6611
  • Fax: 609-893-6038

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number25MB10042900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: