Mary Jane Costanza

Individual provider Active NPI School Registered Nurse · Frankfort, NY

NPI 1639445562 · NPPES record last updated Mar 26, 2012

Key facts

NPI
1639445562
Entity type
Individual (NPI type 1)
Primary specialty
School Registered Nurse 163WS0200X
License
292422-1 (NY)
Practice address
610 Reese Rd
Frankfort, NY 13340-3404
Phone
(315) 895-3007
Fax
(315) 895-4102
NPI assigned
Mar 26, 2012
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
292422-1NYMDSchool Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 292422-1 NY Yes

Addresses

Primary practice location

610 Reese Rd
Frankfort, NY 13340-3404

Mailing address

610 Reese Rd
Frankfort, NY 13340-3404
Phone (315) 895-3007

Other providers in Frankfort, NY

All providers in Frankfort, NY · School Registered Nurse in New York

Sources for this page

Verify at the official NPI Registry.