Individual
RUDY ANTHONY LACOSSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 COOPER PLZ, CAMDEN, NJ 08103-1461
(856) 342-3150
Mailing address
1 FEDERAL ST STE 200, CAMDEN, NJ 08103-1088
(848) 288-6935
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00503700
NJ
363A00000X
Physician Assistant
9109705
FL
363A00000X
Physician Assistant
MA060244
PA
Other
Enumeration date
09/30/2016
Last updated
11/21/2023
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