Jesse Lee Costales M.D.

NPI 1619266897 - Student in an Organized Health Care Education/Training Program - 390200000X

NPI Details
NPI 1619266897
Gender Male
Enumeration Date 03/28/2011
Last Updated 03/31/2016
Entity Type Individual
Active Over 5 years ago
Practice Location
1 GUSTAVE L LEVY PL
DEPARTMENT OF PSYCHIATRY - 4TH FLOOR ICAHN BLDG
NEW YORK NY, 10029-6504, US
Phone (212) 659-9100
Fax
Business Location
1 GUSTAVE L LEVY PL
DEPARTMENT OF PSYCHIATRY - 4TH FLOOR ICAHN BLDG
NEW YORK NY, 10029-6504, US
Phone (212) 659-9100
Fax
Toxanomy
Taxonomy Code 390200000X
License State California
License Number NONE
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According to our database, Dr. Jesse Lee Costales M.D. NPI is 1619266897, taxonomy code is 390200000X and license number is NONE, license state is located at California. Jesse Lee Costales M.D. physically located at 1 Gustave L Levy Pl, New York NY, 10029-6504. NPI Number Jesse Lee Costales M.D. has the Individual type.

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1619266897 NPI number is provided on an as is basis without warranty of any kind. 1619266897 is maintained by the National Plan & Provider Enumeration System. The contents of Jesse Lee Costales M.D. are for informational purposes only.