Individual
CHRISTINA DECOSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
994 W JERICHO TPKE STE 104, SMITHTOWN, NY 11787-3211
(631) 543-1440
Mailing address
994 W JERICHO TPKE STE 104, SMITHTOWN, NY 11787-3211
(631) 543-1440
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
310384
NY
Other
Enumeration date
08/22/2021
Last updated
03/15/2024
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