Individual
LAUREN IRENE KOSSACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1275 YORK AVE, NEW YORK, NY 10065-6007
(212) 639-2000
Mailing address
140 E 28TH ST APT 4K, NEW YORK, NY 10016-0049
(516) 770-3854
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
008241
NY
Other
Enumeration date
02/17/2009
Last updated
01/03/2020
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