Healthcare Provider Details

I. General information

NPI: 1538644737
Provider Name (Legal Business Name): ELENA N COSENZA CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2018
Last Update Date: 03/12/2024
Certification Date: 04/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 ART DILLY DR
AUSTIN TX
78702-5368
US

IV. Provider business mailing address

7207 HOLLY FERN CV
AUSTIN TX
78750-7901
US

V. Phone/Fax

Practice location:
  • Phone: 215-872-2027
  • Fax:
Mailing address:
  • Phone: 215-872-2027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SG0600X
TaxonomyGerontology Clinical Nurse Specialist
License NumberAP139067
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License NumberAP139067
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: