Individual
DR. RICHARD A. KOSTICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-6102
Mailing address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
213740-1
NY
2085R0202X
Diagnostic Radiology Physician
Primary
OS013100
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01990954
—
NY
05
—
1012524710001
—
PA
01
—
CC8362
RR MEDICARE GROUP
NY
01
—
CC9269
RR MEDICARE GROUP
PA
01
—
GU039853
MEDICARE GROUP
PA
01
—
GU058887
MEDICARE GROUP
PA
01
—
P00098797
RR MEDICARE PIN
NY
01
—
P00199377
RR MEDICARE PIN
PA
Enumeration date
03/16/2006
Last updated
03/12/2021
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