Basic Information
| Provider Information | |||||||||
| NPI: | 1336266972 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DAN COSTIN MD PLLC | ||||||||
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| OtherOrganizationName: | WESTCHESTER INSTITUTE FOR TREATMENT OF CANCER & BLOOD DISORDERS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2 LONGVIEW AVE | ||||||||
| Address2: | STE 201 | ||||||||
| City: | WHITE PLAINS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 106015002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9146842779 | ||||||||
| FaxNumber: | 9146846859 | ||||||||
| Practice Location | |||||||||
| Address1: | 2 LONGVIEW AVE | ||||||||
| Address2: | STE 201 | ||||||||
| City: | WHITE PLAINS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 106015002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9146842779 | ||||||||
| FaxNumber: | 9146846859 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/26/2007 | ||||||||
| LastUpdateDate: | 04/23/2010 | ||||||||
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| AuthorizedOfficialLastName: | NELSON | ||||||||
| AuthorizedOfficialFirstName: | BENEDEK | ||||||||
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| AuthorizedOfficialTitleorPosition: | BUSINESS MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 9146842779 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
No ID Information.