Provider Demographics
NPI:1316991771
Name:KOSIN, NEIL I (DC)
Entity type:Individual
Prefix:DR
First Name:NEIL
Middle Name:I
Last Name:KOSIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 794
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-0794
Mailing Address - Country:US
Mailing Address - Phone:732-409-7774
Mailing Address - Fax:732-409-2683
Practice Address - Street 1:25 BROAD ST
Practice Address - Street 2:SPACE 10
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-1901
Practice Address - Country:US
Practice Address - Phone:732-409-7774
Practice Address - Fax:732-409-2683
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC0424100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ786249Medicare ID - Type Unspecified
NJ611700DEYMedicare UPIN