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NPI Code Detail

MEDICARE: MRS. REGINA ANNE COSTANZO APA-C

MEDICARE: MRS. REGINA ANNE COSTANZO APA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171000000XMilitary Health Care Provider
2363A00000XPhysician Assistant

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11164991OTHERNCCPA

General Provider Information

NPI Number : 1144882929
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. REGINA ANNE COSTANZO APA-C
Provider Business Mailing Address
First Line : 1650 17TH ST NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20009-2434
Country : US
Telephone Number : 202-757-2499
Fax Number :
Provider Business Practice Location Address
First Line : 1650 17TH ST NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20009-2434
Country : US
Telephone Number : 202-757-2499
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/02/2019
Last Update Date : 02/10/2025

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Directions to “ MRS. REGINA ANNE COSTANZO APA-C” Practice Location

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