Provider Demographics
NPI:1265155105
Name:COSTE, VANESSA I (OTD, OTR/L)
Entity type:Individual
Prefix:DR
First Name:VANESSA
Middle Name:I
Last Name:COSTE
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1365 SAINT NICHOLAS AVE APT 20R
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-6207
Mailing Address - Country:US
Mailing Address - Phone:347-413-3227
Mailing Address - Fax:
Practice Address - Street 1:1365 SAINT NICHOLAS AVE APT 20R
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-6207
Practice Address - Country:US
Practice Address - Phone:347-413-3227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026604225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist