Individual
DR. ANDREW T. COSTARINO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3401 CIVIC CENTER BLVD STE 9329, PHILADELPHIA, PA 19104-4319
(215) 590-1858
(267) 425-9331
Mailing address
100 E PENN SQUARE, WANAMAKER BLDG., 9TH FL, N, PHILADELPHIA, PA 19104-0001
(267) 425-9320
(267) 425-9331
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
C10006289
DE
207LP3000X
Pediatric Anesthesiology Physician
C10006289
DE
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
C10006289
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1642039
—
NY
05
—
2835100
—
MD
05
—
410070
—
DC
05
—
496804
—
NJ
05
—
6736441
—
VA
05
—
7611115
—
NC
05
—
963171
—
PA
05
—
Q4937E
—
SC
Enumeration date
09/28/2006
Last updated
06/15/2018
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