Nicole Marie Cosar
Individual provider Active NPI Optician · Herkimer, NY
NPI 1841836749 · NPPES record last updated Nov 26, 2019
Key facts
- NPI
- 1841836749
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optician 156FX1800X
- License
- 009641-1 (NY)
- Practice address
- 103 N Caroline St
Herkimer, NY 13350-1716 - Phone
- (315) 717-0264
- Fax
- (315) 717-0266
- NPI assigned
- Nov 26, 2019
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 009641-1 | NY | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 009641-1 | NY | Yes |
Addresses
Primary practice location
103 N Caroline St
Herkimer, NY 13350-1716
Mailing address
126 Manhattan Ave
Ilion, NY 13357-5103
Phone (315) 985-0831
Other providers in Herkimer, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 26, 2019. 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.