Costley, Sandra
Costley, Sandra is an sole proprietor health care provider with primary practice located at 345 N Main St , New City NY 10956-4305. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Costley, Sandra can be contacted via phone (845) 639-3123.Contact Information
Primary practice address
345 N Main St
New City NY 10956-4305
Phone: (845) 639-3123
Fax: (845) 639-4194
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 185092 | New York |
Profile Details
| NPI number | 1174507479 |
|---|---|
| LBN Legal business name | Costley, Sandra |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 1st, 2005 |
| Last updated | Apr 23rd, 2008 - about 16 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 | 1174507479 | NPPES |
| New York | Other | SC089K6010 | MEDICARE UNSPECIFIED |
| New York | MEDICAID | 01584821 | MEDICARE UNSPECIFIED |
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