Individual
GINA L DICOSTANZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2 CENTEROCK RD, WEST NYACK, NY 10994-2215
(845) 703-6999
(845) 703-6297
Mailing address
155 CRYSTAL RUN RD, MIDDLETOWN, NY 10941-4057
(845) 703-6999
(845) 703-6297
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F430385
NY
363LF0000X
Family Nurse Practitioner
NN99267
NJ
Other
Enumeration date
10/17/2006
Last updated
08/11/2020
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