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Individual
NICOLE M COSTANTINI
Active
Individual
NICOLE M COSTANTINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
NULL
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C67395917460002
DRIVERS LICENSE
NJ
Enumeration date
02/03/2023
Last updated
02/03/2023
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