Individual
ERIC COSTANZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2640 HIGHWAY 70 STE 6A, MANASQUAN, NJ 08736-2610
(732) 528-5900
(732) 528-0887
Mailing address
2640 HIGHWAY 70 STE 6A, MANASQUAN, NJ 08736-2610
(732) 528-5900
(732) 528-0887
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
25MB07782000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0138461
—
NJ
Enumeration date
09/27/2006
Last updated
10/08/2018
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