Provider Demographics
NPI:1609966514
Name:ABRAHAM A COSTER DPM LTD
Entity Type:Organization
Organization Name:ABRAHAM A COSTER DPM LTD
Other - Org Name:ALEXANDRIA PODIATRY ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:SAMUEL
Authorized Official - Last Name:COSTER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:703-379-0700
Mailing Address - Street 1:4660 KENMORE AVE
Mailing Address - Street 2:SUITE 608
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-1306
Mailing Address - Country:US
Mailing Address - Phone:703-379-0700
Mailing Address - Fax:703-578-4161
Practice Address - Street 1:4660 KENMORE AVE
Practice Address - Street 2:SUITE 608
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-1306
Practice Address - Country:US
Practice Address - Phone:703-379-0700
Practice Address - Fax:703-578-4161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103000719213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty