Kostenko, Valeriy
Kostenko, Valeriy is an sole proprietor health care provider with primary practice located at 74 Market St , Lynn MA 01901-1115. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Kostenko, Valeriy can be contacted via phone (781) 581-1411.Contact Information
Primary practice address
74 Market St
Lynn MA 01901-1115
Phone: (781) 581-1411
Fax: (781) 581-1433
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 19585 | Massachusetts |
Profile Details
| NPI number | 1104969583 |
|---|---|
| LBN Legal business name | Kostenko, Valeriy |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 15th, 2007 |
| Last updated | Jul 9th, 2007 - about 18 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 | 1104969583 | NPPES |
| Massachusetts | MEDICAID | 0281956 |
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