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Individual

DR. MARK E COSTALDI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
736 IRVING AVE, PATHOLOGY, #9227, SYRACUSE, NY 13210-1687
(315) 470-7396
Mailing address
736 IRVING AVE, PATHOLOGY, #9227, SYRACUSE, NY 13210-1687

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
261809
NY
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
35.093703
OH

Other

Enumeration date
01/11/2008
Last updated
07/31/2012
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