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
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #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 4 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 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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