Provider Demographics
NPI:1528052966
Name:COTTRELL, JAMES E (MD, FRCA)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:E
Last Name:COTTRELL
Suffix:
Gender:M
Credentials:MD, FRCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:450 CLARKSON AVE, BOX 1262
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-2056
Mailing Address - Country:US
Mailing Address - Phone:718-270-8867
Mailing Address - Fax:718-270-1794
Practice Address - Street 1:450 CLARKSON AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2056
Practice Address - Country:US
Practice Address - Phone:718-270-8867
Practice Address - Fax:718-270-1794
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-31
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY120766-1207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00429034Medicaid
NYB78661Medicare UPIN
NY653831Medicare ID - Type Unspecified