Organization
LAKE COUNTY PEDIATRICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CONSTANCIO B ACOSTA MD (PHYSICIAN PEDIATRICIAN)
(219) 736-9580
Entity
Organization
Contact information
Practice address
8500 BROADWAY, STE E, MERRILLVILLE, IN 46410
(219) 736-9580
(219) 736-9581
Mailing address
8500 BROADWAY, STE E, MERRILLVILLE, IN 46410
(219) 736-9580
(219) 736-9581
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01025495
IN
Other
Enumeration date
05/02/2007
Last updated
08/22/2020
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