Individual
DR. ANNA M KOSTANECKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8455 FLYING CLOUD DR, STE 205, EDEN PRAIRIE, MN 55344-3974
(952) 993-2498
Mailing address
3800 PARK NICOLLET BLVD, CREDENTIALING, ST LOUIS PARK, MN 55416-2527
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
230420
NY
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
50277
MN
2080P0006X
Developmental - Behavioral Pediatrics Physician
MD424753
PA
Other
Enumeration date
04/09/2007
Last updated
03/02/2012
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