Individual
ROBERTA DIANNE COSTANZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
37 EASTFIELD LN, MELVILLE, NY 11747-1606
(631) 848-3050
Mailing address
37 EASTFIELD LN, MELVILLE, NY 11747-1606
(631) 848-3050
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F401051-1
NY
Other
Enumeration date
06/03/2016
Last updated
06/03/2016
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