Individual
JACOB KOSYAKOVSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT ST, WANG 021, BOSTON, MA 02114-2696
(612) 791-1350
Mailing address
55 FRUIT ST, WANG 021, BOSTON, MA 02114-2621
(612) 791-1350
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
3014532
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/14/2022
Last updated
08/31/2023
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