Ebony Cosby

Individual provider Active NPI Contractor · Charlottesville, VA

NPI 1649637752 · NPPES record last updated Jan 20, 2016

Key facts

NPI
1649637752
Entity type
Individual (NPI type 1)
Primary specialty
Contractor 171W00000X
Practice address
2500 Boulders Rd
Charlottesville, VA 22911
Phone
(434) 951-4747
NPI assigned
Jan 20, 2016
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X Yes

Addresses

Primary practice location

2500 Boulders Rd
Charlottesville, VA 22911

Mailing address

6387 Center Dr
Suite 9
Norfolk, VA 23502-4109
Phone (757) 461-8820

Other providers in Charlottesville, VA

All providers in Charlottesville, VA · Contractor in Virginia

Sources for this page

Verify at the official NPI Registry.