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General NPI Number Information
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NPI Number | 1750426292
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Entity Type | Individual
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Provider Name | EDWARD JAMES KOSENSKI D.C.
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Gender | Male
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 07/16/2015
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Provider Practice Location Address
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Address Line | 297 MUDDY BRANCH RD
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City | GAITHERSBURG
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State | MD
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Zip | 20878-3000
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Country | US
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Telephone | 301-330-4443
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Fax |
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Provider Business Mailing Address
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Address Line | 6000 LAUREL BOWIE RD 202
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City | BOWIE
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State | MD
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Zip | 20715-4000
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Country | US
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Telephone | 301-352-3454
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Fax | 301-352-0893
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 01764
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License Number State | MD
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