Provider Demographics
NPI:1811159510
Name:KOSTUREK, ANNA B (MD)
Entity type:Individual
Prefix:DR
First Name:ANNA
Middle Name:B
Last Name:KOSTUREK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 W NORTH ST
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16101-3906
Mailing Address - Country:US
Mailing Address - Phone:724-658-3578
Mailing Address - Fax:724-656-1325
Practice Address - Street 1:130 W NORTH ST
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16101-3906
Practice Address - Country:US
Practice Address - Phone:724-658-3578
Practice Address - Fax:724-656-1325
Is Sole Proprietor?:No
Enumeration Date:2008-06-25
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4181022084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA056419Medicare PIN
PAH93252Medicare UPIN