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General NPI Number Information
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NPI Number | 1215056841
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Entity Type | Individual
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Provider Name | JONATHAN KOSE LCSW
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Gender | Male
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 03/08/2012
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Provider Practice Location Address
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Address Line | 173 W 78TH ST SUITE 2A
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City | NEW YORK
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State | NY
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Zip | 10024-6703
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Country | US
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Telephone | 646-236-8387
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Fax |
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Provider Business Mailing Address
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Address Line | 244 W 74TH ST APT 7A
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City | NEW YORK
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State | NY
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Zip | 10023-2115
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Country | US
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Telephone | 212-724-8383
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | PR-022947-1
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License Number State | NY
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