Costanzo, John Jeffrey

Costanzo, John Jeffrey is an individual health care provider with primary practice located at 1040 Waltham St , Lexington MA 02421-8033. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Costanzo, John Jeffrey can be contacted via phone (781) 862-3600.

Contact Information

Primary practice address
1040 Waltham St Lexington MA 02421-8033
Phone: (781) 862-3600
Fax: (781) 863-5903
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X Massachusetts

Profile Details

NPI number 1447311196
LBN Legal business name Costanzo, John Jeffrey
Credentials Master of Arts (MA)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 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 1447311196 NPPES
Massachusetts Other NP01332 BMC
Massachusetts MEDICAID 1303287 BMC
Massachusetts Other 99618201 BMC
Massachusetts Other NHP1004745 BMC
Massachusetts Other 1303287 BMC
Massachusetts Other 703136 BMC
Massachusetts Other M18633 BMC

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