Costanza, Mary E

Costanza, Mary E is an individual health care provider with primary practice located at 55 Lake Ave N Department Of Hematology/Oncology, Worcester MA 01655-0002. She recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as her primary health care specialty. Costanza, Mary E can be contacted via phone (508) 856-3902.

Contact Information

Primary practice address
55 Lake Ave N Department Of Hematology/Oncology Worcester MA 01655-0002
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X 32475 Massachusetts

Profile Details

NPI number 1073596656
LBN Legal business name Costanza, Mary E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 28th, 2005
Last updated Jul 8th, 2007 - about 18 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 1073596656 NPPES
Massachusetts MEDICAID 2047756

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