Daniela Costanzo, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

25MT00282700 Issued in NJ

Practice address

622 Eagle Rock Ave
West Orange, NJ 07052-2994

Phone

(973) 380-0922

NPI assigned

Jan 31, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1643587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643587200000",
    "number": "1972256931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 GATES AVE APT 35",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070422536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 EAGLE ROCK AVE",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522994",
            "telephone_number": "973-380-0922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTANZO",
        "first_name": "DANIELA",
        "credential": "LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-31",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NJ",
            "license": "25MT00282700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corneal Associates of New Jersey
• Karla Ivone Corona Boites, RN
• Nerissa Fe Corpuz, COTA/L
• Patricia Ann Cortina, PT
• Marilu D Coscolluela, PT
• Constantinos Aristides Costeas, M.D.
• Melissa Costello, BCABA
• Julianne Couch, OTR/L
• Kayla Coutts
• James Brown Cowperthwait Jr., LMSW

• Athletic Trainer in West Orange, NJ
• Providers in West Orange, NJ by specialty
• Athletic Trainer in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.