Costanzo, Kathleen A
Costanzo, Kathleen A is an individual health care provider with primary practice located at 311 W 24Th St Ste 305 , Erie PA 16502-2666. She recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as her primary health care specialty. Costanzo, Kathleen A can be contacted via phone (814) 454-4484.Contact Information
Primary practice address
311 W 24Th St Ste 305
Erie PA 16502-2666
Phone: (814) 454-4484
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Sports Medicine | 207QS0010X | OS014849 | Pennsylvania |
Profile Details
| NPI number | 1528349396 |
|---|---|
| LBN Legal business name | Costanzo, Kathleen A |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 7th, 2011 |
| Last updated | Oct 1st, 2020 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1528349396 | NPPES |
| Pennsylvania | Other | 30106933 | AMERIHEALTH MERCY - WMG |
| Pennsylvania | MEDICAID | 441180300 | AMERIHEALTH MERCY - WMG |
| Pennsylvania | Other | 417898 | AMERIHEALTH MERCY - WMG |
| Pennsylvania | Other | 1602874 | AMERIHEALTH MERCY - WMG |
| Pennsylvania | MEDICAID | 102645606 | AMERIHEALTH MERCY - WMG |
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