Provider Demographics
NPI:1063534113
Name:KOSOFSKY, JODI MARGARET (LP PSYA MA)
Entity type:Individual
Prefix:MRS
First Name:JODI
Middle Name:MARGARET
Last Name:KOSOFSKY
Suffix:
Gender:F
Credentials:LP PSYA MA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:23 ZUEGEL COURT
Mailing Address - Street 2:
Mailing Address - City:BERGENFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07621
Mailing Address - Country:US
Mailing Address - Phone:201-385-6534
Mailing Address - Fax:201-385-1552
Practice Address - Street 1:5 WEST 86TH STREET
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024
Practice Address - Country:US
Practice Address - Phone:201-417-4218
Practice Address - Fax:201-385-1552
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000013102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst