Provider Demographics
NPI:1457655045
Name:COSTER, WENDY A (MSN, ANP-C, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:A
Last Name:COSTER
Suffix:
Gender:F
Credentials:MSN, ANP-C, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HARVARD ST
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-3113
Mailing Address - Country:US
Mailing Address - Phone:516-426-6156
Mailing Address - Fax:
Practice Address - Street 1:8 NOVA RD
Practice Address - Street 2:
Practice Address - City:BAYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11709-1410
Practice Address - Country:US
Practice Address - Phone:516-426-6156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-22
Last Update Date:2023-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY530184-1163W00000X
NYF305479-1363LA2200X
NY404331363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered Nurse
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY404331OtherPSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER