Individual
DR. ALEXANDER KOSENKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
350 E BAYFRONT PKWY, UNIT C, ERIE, PA 16507-2410
(814) 455-2279
(814) 871-1786
Mailing address
350 E BAYFRONT PKWY, UNIT C, ERIE, PA 16507-2410
(814) 455-2279
(814) 871-1786
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
35068000
OH
207RN0300X
Nephrology Physician
Primary
MD033699E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010200620005
—
PA
01
—
1356386817
RAILROAD MEDICARE
PA
Enumeration date
06/18/2006
Last updated
11/30/2007
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