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General NPI Number Information
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NPI Number | 1184673055
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Entity Type | Individual
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Provider Name | ALISON J COSTALOS I NP
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Gender | Female
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Dates
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Enumeration Date | 05/09/2006
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Last Update Date | 08/26/2009
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Provider Practice Location Address
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Address Line | 1275 YORK AVE
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City | NEW YORK
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State | NY
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Zip | 10065-2742
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Country | US
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Telephone | 646-422-4329
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Fax |
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Provider Business Mailing Address
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Address Line | 126 HARRISON AVE
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City | WESTFIELD
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State | NJ
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Zip | 07090-2433
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Country | US
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Telephone | 908-654-0617
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | F430168-1
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License Number State | NY
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