Provider Demographics
NPI:1154968469
Name:COSENTINO, SALVATORE ANTHONY (RN)
Entity type:Individual
Prefix:
First Name:SALVATORE
Middle Name:ANTHONY
Last Name:COSENTINO
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 SAINT MARKS PL APT 2H
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301-1662
Mailing Address - Country:US
Mailing Address - Phone:917-375-6229
Mailing Address - Fax:
Practice Address - Street 1:90 SAINT MARKS PL APT 2H
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301-1662
Practice Address - Country:US
Practice Address - Phone:917-375-6629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-05
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY782537163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse