Individual
EDWIN R ACOSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 ROE AVE, ELMIRA, NY 14905-1629
(607) 734-3414
(607) 734-9728
Mailing address
100 E 14TH ST, ELMIRA HEIGHTS, NY 14903-1318
(607) 734-6237
(607) 734-9728
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
207426
NY
2085R0202X
Diagnostic Radiology Physician
Primary
207426-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01759677
—
NY
05
—
1667956
—
PA
Enumeration date
03/09/2006
Last updated
06/29/2023
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