Individual
BENJAMIN ROBERT KOSTEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
10529 S RIVA RIDGE LOOP, FORT DRUM, NY 13602
(315) 774-8155
Mailing address
1 WOODS POND DR, WESTFORD, MA 01886
(978) 654-1296
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1332
NH
2255A2300X
Athletic Trainer
S04697720
MA
Other
Enumeration date
06/28/2017
Last updated
09/02/2022
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