Lisa Marie Cogswell, MS SP. ED., SBL
Individual provider Active NPI Specialist · Baldwin, NY
NPI 1417455676 · NPPES record last updated Jan 23, 2018
Key facts
- NPI
- 1417455676
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 1730721 (NY)
- Practice address
- 2690 Wilddale Rd
Baldwin, NY 11510-4127 - Phone
- (347) 729-8909
- Fax
- (646) 868-1230
- NPI assigned
- Jan 23, 2018
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1730721 | NY | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Early Intervention Provider Agency | 252Y00000X | 1730721 | NY | |
| Specialist | 174400000X | 1730721 | NY | Yes |
Addresses
Primary practice location
2690 Wilddale Rd
Baldwin, NY 11510-4127
Mailing address
2690 Wilddale Rd
Baldwin, NY 11510-4127
Phone (347) 729-8909
Other providers in Baldwin, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 23, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.