Individual
MARY JANE COSTANZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
610 REESE RD, FRANKFORT, NY 13340-3404
(315) 895-3007
(315) 895-4102
Mailing address
610 REESE RD, FRANKFORT, NY 13340-3404
(315) 895-3007
(315) 895-4102
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
292422-1
NY
Other
Enumeration date
03/26/2012
Last updated
03/26/2012
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