Individual
MR. ANTHONY THOMAS COSTANZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
44 JEANETTE AVE, STATEN ISLAND, NY 10312
(718) 816-6608
Mailing address
44 JEANETTE AVE, STATEN ISLAND, NY 10312
(718) 816-6608
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
005105-1
NY
Other
Enumeration date
06/24/2011
Last updated
06/24/2011
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