Costalos, Peter A.

Costalos, Peter A. is an sole proprietor health care provider with primary practice located at 462 Bay Ridge Pkwy , Brooklyn NY 11209-2702. He recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as his primary health care specialty. Costalos, Peter A. can be contacted via phone (718) 238-9888.

Contact Information

Primary practice address
462 Bay Ridge Pkwy Brooklyn NY 11209-2702
Phone: (718) 238-9888
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X 049776 New York

Profile Details

NPI number 1710049408
LBN Legal business name Costalos, Peter A.
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 16th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710049408 NPPES
New York MEDICAID 02395435

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