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General NPI Number Information
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NPI Number | 1508243288
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Entity Type | Organization
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Legal Business Name | KOSYAK CONSULTING
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Dates
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Enumeration Date | 05/01/2015
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Last Update Date | 08/07/2019
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Provider Practice Location Address
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Address Line | 63 SADDLERS RUN
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City | ORMOND BEACH
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State | FL
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Zip | 32174-2456
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Country | US
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Telephone | 386-481-3886
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Fax |
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Provider Business Mailing Address
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Address Line | 38 LAUREL RIDGE BREAK
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City | ORMOND BEACH
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State | FL
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Zip | 32174
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Country | US
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Telephone | 386-235-8760
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. TATIANA E KOSYAK
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Credential | RPH
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Telephone | 386-235-8760
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 11667
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 051.036883
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | PS21364
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License Number State | FL
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