Healthcare Provider Details
I. General information
NPI: 1750309241
Provider Name (Legal Business Name): J & E MEDICAL SPECIALTIES, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/17/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
50 BRIGHAM RD
FREDONIA NY
14063-1004
US
IV. Provider business mailing address
50 BRIGHAM RD
FREDONIA NY
14063-1004
US
V. Phone/Fax
- Phone: 716-672-6662
- Fax:
- Phone: 716-672-6662
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RC0200X |
| Taxonomy | Critical Care Medicine (Internal Medicine) Physician |
| License Number | 239319 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RP1001X |
| Taxonomy | Pulmonary Disease Physician |
| License Number | 239319 |
| License Number State | NY |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 239552 |
| License Number State | NY |
VIII. Authorized Official
Name: DR.
FELIXBERTO
COSICO
Title or Position: PRESIDENT
Credential: M.D.
Phone: 716-672-6673