Individual
MICHELLE KOSTELANSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5401 OLD YORK RD, KLEIN BUILDING SUITE 510, PHILADELPHIA, PA 19141-3030
(215) 456-6930
(215) 456-3529
Mailing address
5401 OLD YORK RD, KLEIN BUILDING SUITE 510, PHILADELPHIA, PA 19141-3030
(215) 456-6930
(215) 456-3529
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
MA057270
PA
Other
Enumeration date
06/22/2015
Last updated
06/22/2015
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