Provider Demographics
NPI:1639249964
Name:COSCIA, SALVATORE ANTHONY (DDS)
Entity type:Individual
Prefix:DR
First Name:SALVATORE
Middle Name:ANTHONY
Last Name:COSCIA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 MORTON BLVD
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-5617
Mailing Address - Country:US
Mailing Address - Phone:917-599-8856
Mailing Address - Fax:
Practice Address - Street 1:96 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:LYNBROOK
Practice Address - State:NY
Practice Address - Zip Code:11563-3461
Practice Address - Country:US
Practice Address - Phone:516-792-6952
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0522281122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist