Individual
DR. JACK COSSMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
20 YORK ST, YALE NEW HAVEN HOSPITAL, NEW HAVEN, CT 06510-3220
(203) 688-4242
Mailing address
3602B LONG BEACH BLVD, BEACH HAVEN, NJ 08008-4139
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD28358
ME
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/19/2014
Last updated
07/01/2024
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