Individual
JOHN D COSACHOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
37 W GARDEN ST STE 206, AUBURN, NY 13021-2657
(315) 252-9562
(315) 255-3872
Mailing address
37 W GARDEN ST STE 206, AUBURN, NY 13021-2657
(315) 252-9562
(315) 255-3872
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
193747
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01572178
—
NY
01
—
035642
MVP
NY
01
—
P010193747
BLUE CHOICE
NY
Enumeration date
09/20/2006
Last updated
07/13/2021
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