Individual
JOHN G COSTINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
404 SURF AVE, NORTH WILDWOOD, NJ 08260-5865
(609) 522-8358
(609) 729-8662
Mailing address
404 SURF AVE, NORTH WILDWOOD, NJ 08260-5865
(609) 522-8358
(609) 729-8662
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
MB02575800
NJ
207Q00000X
Family Medicine Physician
Primary
MB02575800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2808501
—
NJ
Enumeration date
11/10/2005
Last updated
07/18/2007
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