Individual
CHRISTOPHER J COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1800 MULBERRY ST, SCRANTON, PA 18510-2369
(570) 969-8000
Mailing address
17 OAKWOOD DR, WILKES BARRE, PA 18702-7316
(570) 654-2916
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA001311L
PA
Other
Enumeration date
03/02/2006
Last updated
07/08/2007
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