MEDICARE: DRS KOSUNICK & SCOTT INC

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	152W00000X	Optometrist	OH5326	OH

General Provider Information

NPI Number	:	1376681585
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DRS KOSUNICK & SCOTT INC

Provider Business Mailing Address
First Line	:	4786B RIDGE RD
Second Line	:
City	:	BROOKLYN
State	:	OH
Zip	:	44144-3327
Country	:	US
Telephone Number	:	216-398-1436
Fax Number	:	216-398-2572

Provider Business Practice Location Address
First Line	:	4786B RIDGE RD
Second Line	:
City	:	BROOKLYN
State	:	OH
Zip	:	44144-3327
Country	:	US
Telephone Number	:	216-398-1436
Fax Number	:	216-398-2572

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JOSEPHINE M KOSUNICK
Credential	:	O.D.
Telephone Number	:	440-263-6227

Provider Enumeration Date	:	02/01/2007
Last Update Date	:	10/19/2010

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