Individual
DR. JOHN MICHAEL COSTABLE JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 NORTHERN BLVD, STE 106, GREAT NECK, NY 11021-5200
(516) 466-6075
(516) 466-6044
Mailing address
600 NORTHERN BLVD, STE 106, GREAT NECK, NY 11021-5200
(516) 466-6075
(516) 466-6044
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
198554
NY
Other
Enumeration date
06/09/2006
Last updated
07/08/2007
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