Healthcare Provider Details

I. General information

NPI: 1952639007
Provider Name (Legal Business Name): DR. ANDREA B COSSETTINI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2009
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3036 GRAHAM ROAD HEARING AND VISION SERVICES
FALLS CHURCH VA
22042
US

IV. Provider business mailing address

3036 GRAHAM ROAD HEARING AND VISION SERVICES
FALLS CHURCH VA
22042
US

V. Phone/Fax

Practice location:
  • Phone: 571-982-1500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number01185
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: