Individual provider · Type 1 NPI

Gary Costanzo, PA

Medical Physician Assistant · Manchester, NH

NPI number 1417103128 Active

Practice location

1 Elliot Way, Emergency Room
Manchester, NH 03103-3502

Call (603) 663-2830 Map

Fax (603) 663-1849

Mailing address

250 Pleasant Street, Emergency Dept
Concord, NH 03301-2598

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X0686 (NH)

Medical Physician Assistant: Definition to come...

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About NPI 1417103128

Gary Costanzo, PA's National Provider Identifier is 1417103128, issued on Aug 13, 2008. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Manchester, NH. The record was last updated on Oct 14, 2015.