Costley, Elizabeth M

Costley, Elizabeth M is an individual health care provider with primary practice located at 360 Washington Ave , Kingston NY 12401-3702. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Costley, Elizabeth M can be contacted via phone (845) 338-7140.

Contact Information

Primary practice address
360 Washington Ave Kingston NY 12401-3702
Phone: (845) 338-7140
Fax: (845) 338-7141
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 208510-1 New York

Profile Details

NPI number 1679577647
LBN Legal business name Costley, Elizabeth M
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 8th, 2005
Last updated Oct 7th, 2015 - about 10 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 1679577647 NPPES
New York MEDICAID 02099250
New York Other 228061
New York Other 69115
New York Other EM032V1510
New York Other 855858
New York Other 10053448
New York Other 080167991

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