Individual
KATHERINE COSTANZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
282 WASHINGTON ST, HARTFORD, CT 06106-3322
(860) 545-9000
Mailing address
1 PARK RD APT 221, WEST HARTFORD, CT 06119-3803
(860) 202-0984
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/06/2022
Last updated
11/21/2023
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