Individual
IRINA COSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
31 UNION COUNTY PKWY, CLARK, NJ 07066-1917
(908) 531-5543
Mailing address
31 UNION COUNTY PKWY, CLARK, NJ 07066-1917
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NR12516100
NJ
363L00000X
Nurse Practitioner
Primary
26NJ00578500
NJ
Other
Enumeration date
07/28/2015
Last updated
07/28/2015
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