MICHAEL COSTANZO

NEW PROVIDENCE, NJ
NPI1245984665
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: NJ  26NJ01265500)
Additional Taxonomies363LA2200X Nurse Practitioner, Adult Health
(Licence: NJ  26NJ01265500)
363LG0600X Nurse Practitioner, Gerontology
(Licence: NJ  26NJ01265500)
363LP2300X Nurse Practitioner, Primary Care
(Licence: NJ  26NJ01265500)
Enumeration Date2022-02-04
Last Update Date2022-05-25
Business Address
MICHAEL COSTANZO NP
890 MOUNTAIN AVENUE DERMATOLOGY - 3RD FL
NEW PROVIDENCE, NJ 07974
Phone number: 908-277-8668
Mailing Address
MICHAEL COSTANZO NP
1 DIAMOND HILL RD
BERKELEY HEIGHTS, NJ 07922-2104
Phone number: