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Organization

COSLOW & ASSOCIATES LTD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. CARL RICHARD COSLOW (OWNER PRESIDENT)
(260) 422-9372
Entity
Organization

Contact information

Practice address
4656 W JEFFERSON BLVD, SUITE 285, FORT WAYNE, IN 46804-6857
(260) 422-9372
(260) 422-0843
Mailing address
4656 W JEFFERSON BLVD, SUITE 285, FORT WAYNE, IN 46804-6857
(260) 422-9372
(260) 422-0843

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34000209A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000143216
ANTHEM
IN
01
075209000
MAGELLAN
IN
05
200806690A
IN
01
280482
VALUE OPTIONS
IN
01
4405313
AETNA
IN
Enumeration date
09/20/2006
Last updated
12/02/2008
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