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General NPI Number Information
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NPI Number | 1871561571
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Entity Type | Individual
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Provider Name | EDWARD KOSOY M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/09/2006
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Last Update Date | 04/11/2023
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Provider Practice Location Address
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Address Line | 704 PASSAIC AVE
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City | WEST CALDWELL
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State | NJ
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Zip | 07006-6468
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Country | US
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Telephone | 973-771-8601
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Fax | 973-228-3200
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Provider Business Mailing Address
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Address Line | 18 SCHWEINBERG DR
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City | ROSELAND
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State | NJ
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Zip | 07068-1133
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Country | US
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Telephone | 973-627-7888
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Fax | 973-627-7040
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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 | 228980
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25MA07609500
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License Number State | NJ
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