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NPI 1396716593

NPI 1396716593 : EDWARD F COSENTINO DPM : GIRARD, OH

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General NPI Number Information
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    NPI Number           |    1396716593
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    Entity Type          |    Individual 
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    Provider Name        |    EDWARD F COSENTINO DPM
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    01/27/2006
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    Last Update Date     |    04/25/2008
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Provider Practice Location Address
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    Address Line         |    603 N STATE ST 
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    City                 |    GIRARD
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    State                |    OH
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    Zip                  |    44420
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    Country              |    US
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    Telephone            |    330-545-4993
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    Fax                  |    330-545-5200
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Provider Business Mailing Address
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    Address Line         |    603 N STATE ST 
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    City                 |    GIRARD
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    State                |    OH
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    Zip                  |    44420
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    Country              |    US
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    Telephone            |    330-545-4993
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    Fax                  |    330-545-5200
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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        |    213EP1101X
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    Taxonomy Name        |    Primary Podiatric Medicine Podiatrist
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    License Number       |    2089
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    License Number State |    OH
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Taxonomy #2
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    Taxonomy Code        |    213E00000X
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    Taxonomy Name        |    Podiatrist
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    License Number       |    2089
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    License Number State |    OH
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