Peter A. Costalos in Brooklyn - Orthodontics And Dentofacial Orthopedics
Peter A. Costalos - NPI 1710049408
Peter A. Costalos is a Orthodontics And Dentofacial Orthopedics in Brooklyn, New York. Peter A. Costalos practices all healthcare services and medical treatments related to Orthodontics And Dentofacial Orthopedics. The NPI Number for Peter A. Costalos is 1710049408. The last update date is 2007-07-08.
Peter A. Costalos's current location address is 462 Bay Ridge Pkwy, Brooklyn, New York. You can contact this provider via phone number 7182389888. The mailing address for Peter A. Costalos is 462 Bay Ridge Pkwy, Brooklyn, New York. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Peter A. Costalos |
|---|---|
| Address | 462 Bay Ridge Pkwy, Brooklyn, New York |
| Phone Number | 7182389888 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | D.M.D. |
NPI Number Detail
| NPI Number | 1710049408 |
|---|---|
| Provider Enumeration Date | 2006-12-16 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 462 Bay Ridge Pkwy |
|---|---|
| City | Brooklyn |
| State | New York (NY) |
| Post Code | 112092702 |
| Phone Number | 7182389888 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Orthodontics And Dentofacial Orthopedics |
|---|---|
| Taxonomy | 1223X0400X |
| Licence No | 49776 |
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Definition: That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their rel |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 2395435 | NY | -- |
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What is the Peter A. Costalos's unique identification number?
The Peter A. Costalos has been assigned the NPI (National Provider Identifier) Number 1710049408 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Where is the Peter A. Costalos located?
The Peter A. Costalos is located at 462 Bay Ridge Pkwy, Brooklyn, NY 112092702.
What is Peter A. Costalos's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Peter A. Costalos's specialized field of practice is Orthodontics And Dentofacial Orthopedics, and the corresponding taxonomy code that categorizes this area of specialization is 1223X0400X.
On what date did the Centers for Medicare & Medicaid Services issue the 1710049408 to Peter A. Costalos?
The Peter A. Costalos received its 1710049408 assignment from the Centers for Medicare & Medicaid Services on 2006-12-16.
As of what date were the details related to Peter A. Costalos most recently updated or revised?
The information pertaining to Peter A. Costalos, including its address, specialty, and other relevant details, was last updated or revised on 2007-07-08.
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