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Individual

DR. GARY JON KOKOSKY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
147 PALMER PARK MALL, EASTON, PA 18045-2759
(610) 258-4372
(610) 258-5878
Mailing address
3220 GLASE RD, DANIELSVILLE, PA 18038-9692
(610) 837-2394

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG-000213
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
50023492
CAPITAL BC
PA
01
MA887976
BLUE SHIELD
PA
Enumeration date
01/29/2007
Last updated
01/03/2008
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