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General NPI Number Information
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NPI Number | 1245835982
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Entity Type | Individual
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Provider Name | GINA ANN KOSAKOWSKI
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Gender | Female
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Dates
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Enumeration Date | 12/01/2020
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Last Update Date | 12/01/2020
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Provider Practice Location Address
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Address Line | CVS PHARMACY 107 MORRISTOWN ROAD SUITE B
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City | BERNARDSVILLE
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State | NJ
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Zip | 07924
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Country | US
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Telephone | 908-221-0871
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Fax |
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Provider Business Mailing Address
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Address Line | 42 ETON PL
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City | BASKING RIDGE
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State | NJ
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Zip | 07920-2304
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Country | US
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Telephone | 917-337-3323
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 28RJ01947
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License Number State | NJ
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