| Doctor Name: | DR. PETER COSTA |
| NPI Number: | 1629048137 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.P.M. |
| License Number: | N39101 |
| Business Practice Address: | 7 Liberty Square Mall Stony Point, NY - 109802400 |
| Business Phone Number: | 8454290520 |
| Business Fax Number: | 8454290603 |
| Mailing Address: | 7 Liberty Square Mall, STONY POINT |
| State: | NY |
| Postal Code: | 109802400 |
| Phone Number: | 8454290520 |
| Fax Number: | 8454290603 |
| NPI Enumeration Date: | 01/25/2006 |
| NPI Last Update Date: | 06/19/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0131X |
| License Number: | N39101 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot Surgery |
| Taxonomy Definition: | |