Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 185812 | NY |
NPI | 1033103155 |
---|---|
Provider Name | Dr. Dan Costin |
First Address | White Plains, NY 10601-5002 |
Second Address | White Plains, NY 10601-5002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2005 |
Last Update Date | 12/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F53185 | (02) |