Provider Demographics
NPI:1982043303
Name:COSTA, SANDRA CHRISTINA (MS ED)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:CHRISTINA
Last Name:COSTA
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 YONKERS TER
Mailing Address - Street 2:3A
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10704-3345
Mailing Address - Country:US
Mailing Address - Phone:914-774-6350
Mailing Address - Fax:
Practice Address - Street 1:50 YONKERS TER
Practice Address - Street 2:3A
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10704-3345
Practice Address - Country:US
Practice Address - Phone:914-774-6350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-19
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1126472174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist