Individual
REGINA M COSTROFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
630 MANTUA PIKE, WOODBURY, NJ 08096
(856) 812-2220
Mailing address
5000 COX RD, GLEN ALLEN, VA 23060-9263
(804) 968-5700
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP0050660
NJ
363A00000X
Physician Assistant
C5-0001277
DE
Other
Enumeration date
12/10/2018
Last updated
03/24/2021
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