Provider Demographics
NPI:1043423882
Name:COSGROVE CONSULTATIONS INC.
Entity type:Organization
Organization Name:COSGROVE CONSULTATIONS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:COSGROVE
Authorized Official - Suffix:
Authorized Official - Credentials:NPP
Authorized Official - Phone:516-785-5544
Mailing Address - Street 1:3375 PARK AVE
Mailing Address - Street 2:SUITE 3007
Mailing Address - City:WANTAGH
Mailing Address - State:NY
Mailing Address - Zip Code:11793-3733
Mailing Address - Country:US
Mailing Address - Phone:516-785-5544
Mailing Address - Fax:516-785-5570
Practice Address - Street 1:3375 PARK AVE
Practice Address - Street 2:SUITE 3007
Practice Address - City:WANTAGH
Practice Address - State:NY
Practice Address - Zip Code:11793-3733
Practice Address - Country:US
Practice Address - Phone:516-785-5544
Practice Address - Fax:516-785-5570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF400581-1363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02154736Medicaid
NY02154736Medicaid
NYP18888Medicare UPIN