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General NPI Number Information
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NPI Number | 1275687444
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Entity Type | Individual
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Provider Name | DIANE STUMPF-KOSTER M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 600 W 168TH ST
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City | NEW YORK
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State | NY
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Zip | 10032-3722
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Country | US
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Telephone | 212-795-0880
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Fax | 212-740-5545
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Provider Business Mailing Address
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Address Line | 1919 CLINTONVILLE ST
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City | WHITESTONE
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State | NY
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Zip | 11357-3816
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Country | US
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Telephone | 718-746-0736
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Fax | 212-740-5545
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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 | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | 188332
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License Number State | NY
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