| Doctor Name: | MR. VINCENT P KOSTOLNI |
| NPI Number: | 1083940134 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LMHC, NCC, CASAC-T |
| License Number: | 004313 |
| Business Practice Address: | 18 Gardenia Ln Levittown, NY - 117563306 |
| Business Phone Number: | 5187444729 |
| Business Fax Number: | |
| Mailing Address: | 18 Gardenia Ln, LEVITTOWN |
| State: | NY |
| Postal Code: | 117563306 |
| Phone Number: | 5187444729 |
| Fax Number: | |
| NPI Enumeration Date: | 10/25/2009 |
| NPI Last Update Date: | 02/02/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 004313 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |