MEDICARE: MR. ALEXANDER CHARLES KOCSY

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	183500000X	Pharmacist	RP039859L	PA

General Provider Information

NPI Number	:	1881008423
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ALEXANDER CHARLES KOCSY

Provider Business Mailing Address
First Line	:	3 KENWOOD CT
Second Line	:
City	:	MALVERN
State	:	PA
Zip	:	19355-1043
Country	:	US
Telephone Number	:	610-213-0886
Fax Number	:

Provider Business Practice Location Address
First Line	:	11750 BUSTLETON AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19116-2516
Country	:	US
Telephone Number	:	215-464-3171
Fax Number	:

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

Provider Enumeration Date	:	06/11/2014
Last Update Date	:	06/11/2014

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Directions to “ MR. ALEXANDER CHARLES KOCSY ” Practice Location

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