Provider Demographics
NPI:1508460361
Name:COSTA-STANTON, ASHLEY N
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:N
Last Name:COSTA-STANTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:939 BREESOPRT RD
Mailing Address - Street 2:
Mailing Address - City:ERIN
Mailing Address - State:NY
Mailing Address - Zip Code:14838
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:939 BREESOPRT RD
Practice Address - Street 2:
Practice Address - City:ERIN
Practice Address - State:NY
Practice Address - Zip Code:14838
Practice Address - Country:US
Practice Address - Phone:607-857-1408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-23
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No174N00000XOther Service ProvidersLactation Consultant, Non-RN