Provider Demographics
NPI:1427162502
Name:KOSKO, GERARD-M. (DC)
Entity type:Individual
Prefix:DR
First Name:GERARD-M.
Middle Name:
Last Name:KOSKO
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 1:1010 EICHELBERGER ST STE 3
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-1374
Mailing Address - Country:US
Mailing Address - Phone:717-632-3700
Mailing Address - Fax:717-632-3369
Practice Address - Street 1:1010 EICHELBERGER ST STE 3
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-1374
Practice Address - Country:US
Practice Address - Phone:717-632-3700
Practice Address - Fax:717-632-3369
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC008690111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU56839Medicare UPIN
PA092186UT8Medicare PIN