Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 200486 | NY |
N | 2080A0000X | Adolescent Medicine | MA65126 | NJ |
NPI | 1013977651 |
---|---|
Provider Name | Dr. Sophia Gigos-Costeas |
First Address | West Caldwell, NJ 07006-7130 |
Second Address | Bronx, NY 10460-5802 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2006 |
Last Update Date | 13/11/2019 |