MEDICARE: TED KOSENSKE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	MX006698	PA
2	207LP2900X	Pain Medicine (Anesthesiology) Physician	MD043353L	PA

General Provider Information

NPI Number	:	1275517641
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TED KOSENSKE MD

Provider Business Mailing Address
First Line	:	PO BOX 947
Second Line	:
City	:	CHAMBERSBURG
State	:	PA
Zip	:	17201-0947
Country	:	US
Telephone Number	:	717-263-5562
Fax Number	:	717-263-1566

Provider Business Practice Location Address
First Line	:	2501 N 3RD ST
Second Line	:	LANDIS BUILDING
City	:	HARRISBURG
State	:	PA
Zip	:	17110-1904
Country	:	US
Telephone Number	:	717-782-6831
Fax Number	:	717-782-6831

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2005
Last Update Date	:	11/29/2023

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