Individual
KELLY COSGROVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
375 W ONONDAGA ST, SUITE 10, SYRACUSE, NY 13202-1888
(315) 478-2030
(315) 478-2250
Mailing address
518 JAMES ST, SUITE 240, SYRACUSE, NY 13203-2238
(315) 476-2030
(315) 478-2255
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
557343
NY
Other
Enumeration date
10/12/2016
Last updated
10/12/2016
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