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Individual
DR. NICHOLAS JOHN COSTANZO
Active
Individual
DR. NICHOLAS JOHN COSTANZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
060416
CT
2086S0102X
Surgical Critical Care Physician
Primary
060416
CT
2086S0127X
Trauma Surgery Physician
060416
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/08/2013
Last updated
10/20/2019
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