Provider Demographics
NPI:1578720082
Name:KOSTER, ADRIANNE R (DDS)
Entity Type:Individual
Prefix:DR
First Name:ADRIANNE
Middle Name:R
Last Name:KOSTER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 W 16TH ST
Mailing Address - Street 2:APT 4
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-6123
Mailing Address - Country:US
Mailing Address - Phone:917-589-4775
Mailing Address - Fax:
Practice Address - Street 1:30 CENTRAL PARK S
Practice Address - Street 2:12 B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1628
Practice Address - Country:US
Practice Address - Phone:212-685-4048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052145-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist