Costanza, Carl

Costanza, Carl is an individual health care provider with primary practice located at 187 Chestnut St , Nutley NJ 07110-2311. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Costanza, Carl can be contacted via phone (973) 667-4402.

Contact Information

Primary practice address
187 Chestnut St Nutley NJ 07110-2311
Phone: (973) 667-4402
Fax: (973) 667-6974
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MA059660 New Jersey

Profile Details

NPI number 1669400651
LBN Legal business name Costanza, Carl
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 29th, 2006
Last updated Sep 9th, 2009 - about 16 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 1669400651 NPPES
New Jersey Other 0814788000 AMERIHEALTH
New Jersey MEDICAID 6583709 AMERIHEALTH

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