Individual
DR. MICHAEL LEONARD COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
2572 43RD ST, ASTORIA, NY 11103-2509
(516) 670-5325
Mailing address
2572 43RD ST, ASTORIA, NY 11103-2509
(516) 670-5325
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
NY
Other
Enumeration date
05/24/2021
Last updated
05/24/2021
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