Individual
MR. VINCENT COSTAGLIOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CTRS
Contact information
Practice address
2724 BAYVIEW AVE, WANTAGH, NY 11793-4310
(516) 754-2367
Mailing address
2724 BAYVIEW AVE, WANTAGH, NY 11793-4310
(516) 754-2367
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
68106
NY
Other
Enumeration date
08/30/2022
Last updated
08/30/2022
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