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General NPI Number Information
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NPI Number | 1265502033
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Entity Type | Organization
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Legal Business Name | CNY ASTHMA & ALLERGY CONSULTANTS PC
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 08/03/2021
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Provider Practice Location Address
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Address Line | 37 WEST GARDEN ST SUITE 206
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City | AUBURN
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State | NY
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Zip | 13021
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Country | US
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Telephone | 315-252-9562
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Fax | 315-255-3872
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Provider Business Mailing Address
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Address Line | 37 WEST GARDEN ST SUITE 206
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City | AUBURN
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State | NY
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Zip | 13021
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Country | US
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Telephone | 315-252-9562
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Fax | 315-255-3872
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Authorized Official
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Title or Position | PHYSICIAN PRESIDENT
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Name | JOHN D COSACHOV
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Credential | DO
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Telephone | 315-252-9562
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number |
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License Number State |
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