MEDICARE: DR. PAUL MICHAEL KOSMORSKY D.O.

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	207Q00000X	Family Medicine Physician	OS007133L	PA

General Provider Information

NPI Number	:	1518921691
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL MICHAEL KOSMORSKY D.O.

Provider Business Mailing Address
First Line	:	303 FLORAL VALE BLVD
Second Line	:
City	:	YARDLEY
State	:	PA
Zip	:	19067-5525
Country	:	US
Telephone Number	:	215-860-1500
Fax Number	:	215-860-7933

Provider Business Practice Location Address
First Line	:	303 FLORAL VALE BLVD
Second Line	:
City	:	YARDLEY
State	:	PA
Zip	:	19067-5525
Country	:	US
Telephone Number	:	215-860-1500
Fax Number	:	215-860-7933

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

Provider Enumeration Date	:	04/14/2006
Last Update Date	:	10/20/2010

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