Provider Demographics
NPI:1275627010
Name:COSTONIS, SARAH C (AP)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:C
Last Name:COSTONIS
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2421 8TH ST
Mailing Address - Street 2:APT 22
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34237-4455
Mailing Address - Country:US
Mailing Address - Phone:941-284-8299
Mailing Address - Fax:
Practice Address - Street 1:2421 8TH ST
Practice Address - Street 2:APT 22
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237-4455
Practice Address - Country:US
Practice Address - Phone:941-284-8299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2192171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist