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NPI Code Detail

MEDICARE: EMMA ROSE KOSTIAK BSN, RN

MEDICARE: EMMA ROSE KOSTIAK BSN, RN
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
1367500000XCertified Registered Nurse AnesthetistRN638384PA

General Provider Information

NPI Number : 1992340731
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMMA ROSE KOSTIAK BSN, RN
Provider Business Mailing Address
First Line : 204 SPRING RUN DR
Second Line :
City : MONROEVILLE
State : PA
Zip : 15146-3395
Country : US
Telephone Number : 570-351-2689
Fax Number :
Provider Business Practice Location Address
First Line : 3500 VICTORIA ST
Second Line :
City : PITTSBURGH
State : PA
Zip : 15213-2543
Country : US
Telephone Number : 888-747-0794
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2019
Last Update Date : 05/28/2021

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