Individual
DR. CAROL VR DE COSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
142 JORALEMON ST, SUITE 3A, BROOKLYN, NY 11201-4747
(718) 852-6949
(718) 852-7075
Mailing address
142 JORALEMON ST, SUITE 3A, BROOKLYN, NY 11201-4747
(718) 852-6949
(718) 852-7075
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
183780
NY
208100000X
Physical Medicine & Rehabilitation Physician
A183780
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01862922
—
NY
Enumeration date
09/20/2006
Last updated
03/10/2015
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