Individual
DR. NICHOLAS PAUL COSENTINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O
Contact information
Practice address
1650 COWLES ST, FAIRBANKS, AK 99701
(907) 458-5358
Mailing address
673RD MDG, 5955 ZEAMER AVE, ANCHORAGE, AK 99506-3702
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
11023
AK
208D00000X
General Practice Physician
0102203678
VA
Other
Enumeration date
05/14/2012
Last updated
06/18/2019
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