Individual
VICTORIA COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 COMMUNITY DR, MANHASSET, NY 11030-3816
(165) 562-1694
Mailing address
300 COMMUNITY DR, MANHASSET, NY 11030-3816
(165) 562-1694
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
307795
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/14/2017
Last updated
08/22/2022
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