Provider Demographics
NPI:1558117317
Name:COSYTEL SERVICES LLC
Entity type:Organization
Organization Name:COSYTEL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ETHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:EMENOGU
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, NP, FNP
Authorized Official - Phone:323-400-4271
Mailing Address - Street 1:2916 W 134TH PL
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90249-1523
Mailing Address - Country:US
Mailing Address - Phone:323-400-4271
Mailing Address - Fax:
Practice Address - Street 1:10910 LONG BEACH BLVD STE 106
Practice Address - Street 2:
Practice Address - City:LYNWOOD
Practice Address - State:CA
Practice Address - Zip Code:90262-2687
Practice Address - Country:US
Practice Address - Phone:323-400-4271
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-24
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty