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General NPI Number Information
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NPI Number | 1417250135
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Entity Type | Organization
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Legal Business Name | ALFRED J. COSSARI, M.D., P.C.
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Dates
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Enumeration Date | 12/20/2010
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Last Update Date | 12/20/2010
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Provider Practice Location Address
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Address Line | 311 BARNUM AVE
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City | PORT JEFFERSON
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State | NY
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Zip | 11777-1682
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Country | US
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Telephone | 631-928-6400
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Fax | 631-928-2353
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Provider Business Mailing Address
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Address Line | 31 BARNUM AVENUE
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City | PORT JEFFERSON
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State | NY
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Zip | 11777
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Country | US
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Telephone | 631-928-6400
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Fax | 631-928-2353
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALFRED J COSSARI
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Credential | MD
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Telephone | 631-928-6400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 119075
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License Number State | NY
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