Organization
JOHN G COSTINO DO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN G COSTINO DO (OWNER)
(609) 522-8358
Entity
Organization
Contact information
Practice address
404 SURF AVE, NORTH WILDWOOD, NJ 08260-5865
(609) 522-8358
Mailing address
404 SURF AVE, NORTH WILDWOOD, NJ 08260-5865
(609) 522-8358
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MB02575800
NJ
207QS0010X
Sports Medicine (Family Medicine) Physician
MB02575800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2808501
—
NJ
Enumeration date
04/13/2006
Last updated
01/31/2008
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