Provider Demographics
NPI:1902598311
Name:COGNOSIS
Entity Type:Organization
Organization Name:COGNOSIS
Other - Org Name:COGNOSIS HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DEFEO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:551-500-5708
Mailing Address - Street 1:541 CEDAR HILL AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:WYCKOFF
Mailing Address - State:NJ
Mailing Address - Zip Code:07481-2133
Mailing Address - Country:US
Mailing Address - Phone:551-444-0924
Mailing Address - Fax:866-315-8961
Practice Address - Street 1:541 CEDAR HILL AVE STE 2
Practice Address - Street 2:
Practice Address - City:WYCKOFF
Practice Address - State:NJ
Practice Address - Zip Code:07481-2133
Practice Address - Country:US
Practice Address - Phone:551-444-0924
Practice Address - Fax:866-315-8961
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-24
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty