Individual
DANIELA COSTANZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
622 EAGLE ROCK AVE, WEST ORANGE, NJ 07052-2994
(973) 380-0922
Mailing address
125 GATES AVE APT 35, MONTCLAIR, NJ 07042-2536
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00282700
NJ
Other
Enumeration date
01/31/2022
Last updated
01/31/2022
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