1568421238 NPI number — MR. LEWIS COSMANO LCSW

Table of content: MR. LEWIS COSMANO LCSW (NPI 1568421238)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568421238 NPI number — MR. LEWIS COSMANO LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COSMANO
Provider First Name:
LEWIS
Provider Middle Name:
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1568421238
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/03/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
238 2ND ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLIFTON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07011-2656
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-478-4360
Provider Business Mailing Address Fax Number:
973-478-6039

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
238 2ND ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLIFTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07011-2656
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-478-4360
Provider Business Practice Location Address Fax Number:
973-478-6039
Provider Enumeration Date:
03/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  44SC00157400 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1041C0700X , with the licence number: PRO29397-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 112768000 . This is a "MAGELLAN" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 112768000 . This is a "NY MAGELLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 7496493 . This is a "NY-GHI-BMP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: PVB78851 . This is a "APS HEALTHCARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0004341394 . This is a "AETNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 44SC00157400 . This is a "LICENCED CLINICAL SWER" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 7496493 . This is a "GHI-BMP" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: N8D51 . This is a "BLUE CROSS & BLUE SHIELD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: N99971 . This is a "BLUE CROSS & BLUE SHIELD" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: PRO29397 . This is a "CLINICAL SOCIAL WORKER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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