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Individual
DR. SUSAN E KOSTENBLATT
Active
Individual
DR. SUSAN E KOSTENBLATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD028675E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01054104
CAPITAL BLUE CROSS
PA
01
—
080050616
PALMETTO RR
PA
01
—
404772
HIGHMARK PA BLUE SHIELD
PA
Enumeration date
05/16/2006
Last updated
08/12/2016
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