Candice Costanzo

NPI #1477955268 in Clay, New York

Provider Information

NPI Number: 1477955268
Entity Type: Individual
Name: Candice Costanzo
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Enumeration Date: Sep 23, 2014
Last Updated: Sep 23, 2014

Practice Location

Address: 5235 POTENZA DR
City: Clay
State: New York
ZIP Code: 13041-8813
Phone: (315) 699-6998

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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