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General NPI Number Information
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NPI Number | 1932301736
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Entity Type | Individual
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Provider Name | ALANE BETH COSTANZO M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/04/2007
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Last Update Date | 06/06/2023
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Provider Practice Location Address
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Address Line | 70 EAST ST
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City | METHUEN
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State | MA
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Zip | 01844-4597
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Country | US
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Telephone | 888-675-7246
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Fax | 508-674-4626
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Provider Business Mailing Address
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Address Line | 34800 BOB WILSON DRIVE BUILDING ONE, PAIN CLINIC, 4 NORTH
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City | SAN DIEGO
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State | CA
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Zip | 92134
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Country | US
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Telephone | 619-532-8937
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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 | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | C56116
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 234831
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License Number State | MA
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