Individual
MEGHAN RYAN COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
736 IRVING AVE, SUITE 9100 NEONATAL ASSOCIATES OF CENTRAL NEW YORK P.C., SYRACUSE, NY 13210
(315) 470-7379
(315) 470-2923
Mailing address
736 IRVING AVE, SUITE 910 NEONATAL ASSOCIATES OF CENTRAL NEW YORK P.C., SYRACUSE, NY 13210-1690
(315) 470-7379
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
015310-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015310-1
NEW YORK STATE LICENSE
NY
Enumeration date
03/02/2012
Last updated
03/02/2012
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