Provider Demographics
NPI:1427527431
Name:COZZOLINO, STEPHEN ANDREW
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:ANDREW
Last Name:COZZOLINO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:816 S 13TH ST # 2F
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-2636
Mailing Address - Country:US
Mailing Address - Phone:610-592-4798
Mailing Address - Fax:
Practice Address - Street 1:3437 MACARTHUR RD
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:PA
Practice Address - Zip Code:18052-2905
Practice Address - Country:US
Practice Address - Phone:610-740-9890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-19
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist