Healthcare Provider Details

I. General information

NPI: 1962503425
Provider Name (Legal Business Name): NORBERT BASIL KOSINSKI DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1354 UNION ST
SCHENECTADY NY
12308-3034
US

IV. Provider business mailing address

1354 UNION ST
SCHENECTADY NY
12308-3034
US

V. Phone/Fax

Practice location:
  • Phone: 518-370-4331
  • Fax: 518-372-9256
Mailing address:
  • Phone: 518-370-4331
  • Fax: 518-372-9256

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0000X
TaxonomySports Medicine Podiatrist
License NumberN002213
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: