Individual
DR. JOHN MICHAEL COSTABLE JR.
Active
Sole proprietor
No
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
07/13/2026
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