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General NPI Number Information
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NPI Number | 1518930429
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Entity Type | Individual
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Provider Name | STEPHAN JOHN KOSMORSKY D.O.
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Gender | Male
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Dates
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Enumeration Date | 02/10/2006
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Last Update Date | 03/23/2016
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Provider Practice Location Address
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Address Line | 23 CAMBRIDGE LN
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City | NEWTOWN
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State | PA
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Zip | 18940-3326
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Country | US
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Telephone | 215-504-0414
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Fax | 215-504-4002
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Provider Business Mailing Address
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Address Line | 1331 ALBRIGHT DR
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City | YARDLEY
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State | PA
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Zip | 19067-2840
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Country | US
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Telephone | 215-321-3351
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Fax | 215-321-4170
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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 | OS004621L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | OS004621L
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License Number State | PA
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