Individual
DR. DEBORAH JULIA KOSTIANOVSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1417 W OREGON AVE, PHILADELPHIA, PA 19145-4926
(215) 334-1311
(215) 334-4512
Mailing address
1409 LOMBARD ST, PHILADELPHIA, PA 19146-1656
(215) 334-1311
(215) 545-0828
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
MD-045243-L
PA
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
MD-045243-L
PA
Other
Enumeration date
11/03/2008
Last updated
11/03/2008
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