MEDICARE: PAUL M. KOSMORSKY D.O.P.C.

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	:	1699960591
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAUL M. KOSMORSKY D.O.P.C.

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	:	OWNER/PHYSICIAN
Name	:	DR. PAUL M. KOSMORSKY
Credential	:	D.O.
Telephone Number	:	215-860-2548

Provider Enumeration Date	:	09/13/2007
Last Update Date	:	06/05/2013

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