Organization
CORELIFE VALLEY, LLC
Active
Other names
CoreLife
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAYMOND JOSEPH KOSTKOWSKI (CEO)
(410) 991-0044
Entity
Organization
Contact information
Practice address
3601 CHICHESTER AVE UNIT 101, UPPER CHICHESTER, PA 19061-3149
(484) 768-6762
(855) 772-4748
Mailing address
1111 BENFIELD BLVD STE 250, MILLERSVILLE, MD 21108-3005
(800) 905-3261
(855) 772-4748
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
10/23/2019
Last updated
10/25/2021
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