Individual
MR. ERIC DONALD COSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
ONE PARK WAY, SENECA, PA 16346-0802
(814) 676-5444
(814) 676-0342
Mailing address
PO BOX 802, SENECA, PA 16346-0802
(814) 676-5444
(814) 676-0342
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
MA001759-L
PA
363AM0700X
Medical Physician Assistant
Primary
OA000770
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA001759L
STATE LICENSE
PA
Enumeration date
03/02/2009
Last updated
07/19/2011
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