Individual
MATHEW J COSENZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
280 PATTONSVILLE RD, JACKSON, OH 45640-9452
(855) 446-5937
(740) 395-8834
Mailing address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 446-5418
(740) 446-5958
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
34006288
OH
207YS0123X
Facial Plastic Surgery Physician
34006288
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000260440
ANTHEM BLUE CROSS
OH
01
—
2211949
RAILROAD MEDICARE
OH
05
—
2211949
—
OH
01
—
7664166
AETNA
—
01
—
8949866
CIGNA
—
Enumeration date
11/17/2005
Last updated
01/21/2021
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