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General NPI Number Information
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NPI Number | 1295798262
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Entity Type | Individual
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Provider Name | MICHAEL S. KOCINSKI D.O.
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Gender | Male
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Dates
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Enumeration Date | 04/10/2006
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Last Update Date | 10/31/2024
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Provider Practice Location Address
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Address Line | 6410 NEW JERSEY AVE
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City | WILDWOOD CREST
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State | NJ
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Zip | 08260-1216
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Country | US
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Telephone | 609-523-1331
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Fax | 609-522-1516
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Provider Business Mailing Address
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Address Line | 6410 NEW JERSEY AVE
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City | WILDWOOD CREST
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State | NJ
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Zip | 08260-1216
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Country | US
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Telephone | 609-523-1331
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Fax | 609-522-1516
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 54675
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS 009951L
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25MB07045200
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License Number State | NJ
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