MEDICARE: DR. KATIUSCA A ACOSTA MD

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
1	208000000X	Pediatrics Physician	287862	NY

General Provider Information

NPI Number	:	1922304609
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATIUSCA A ACOSTA MD

Provider Business Mailing Address
First Line	:	1572 NEW YORK AVE
Second Line	:
City	:	HUNTINGTON STATION
State	:	NY
Zip	:	11746-2418
Country	:	US
Telephone Number	:	631-425-5250
Fax Number	:	631-425-0140

Provider Business Practice Location Address
First Line	:	1572 NEW YORK AVE
Second Line	:
City	:	HUNTINGTON STATION
State	:	NY
Zip	:	11746-2418
Country	:	US
Telephone Number	:	631-425-5250
Fax Number	:	631-425-0140

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/28/2011
Last Update Date	:	03/18/2025

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