Basic Information
| Provider Information | |||||||||
| NPI: | 1821225715 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COSENTINO | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | PATRICK | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 301 BINGHAM AVENUE, SUITE B | ||||||||
| Address2: | |||||||||
| City: | OCEAN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07712 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7325751100 | ||||||||
| FaxNumber: | 7325751107 | ||||||||
| Practice Location | |||||||||
| Address1: | 301 BINGHAM AVENUE, SUITE B | ||||||||
| Address2: | |||||||||
| City: | OCEAN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07712 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7325751100 | ||||||||
| FaxNumber: | 7325751107 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/17/2009 | ||||||||
| LastUpdateDate: | 02/27/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RP1001X | 25MB09817300 | NJ | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
ID Information
| ID | Type | State | Issuer | Description | 0306037 | 05 | NJ | MEDICAID |