Individual
DR. GEORGE J COSTANZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
340 N MAIN ST, SOUTHINGTON, CT 06489-2529
(860) 621-0131
(860) 621-1533
Mailing address
340 N MAIN ST, SOUTHINGTON, CT 06489-2529
(860) 621-0131
(860) 621-1533
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
8461
CT
Other
Enumeration date
05/10/2006
Last updated
09/06/2019
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