National Provider Identifier
Stephanie Elaine-Marie Costantino
Stephanie Elaine-Marie Costantino is listed in the NPPES registry with a primary specialty of Speech-Language Pathologist in Fairport, NY and a listed phone number of (585) 377-4660.
Profile Overview
- NPI
- 1265785612
- Provider Type
- Individual
- Primary Specialty
- Speech-Language Pathologist
- Enumeration Date
- October 23, 2012
- Last Updated
- October 04, 2021
Practice Location
- 41 Oconnor RD
- Fairport, NY 14450-1327
Phone: (585) 377-4660
Specialties
- Speech-Language Pathologist (235Z00000X)
- Speech-Language Pathologist (235Z00000X)
Full Record
- NPI
- 1265785612
- Entity Type
- Individual
- Last Name
- Costantino
- First Name
- Stephanie
- Middle Name
- Elaine-Marie
- Name Prefix
- Mrs.
- Provider Other Last Name
- Sobaszek
- Provider Other First Name
- Stephanie
- Provider Other Name Prefix Text
- Miss
- Provider Other Last Name Type Code
- 1
- Mailing Street Address
- 41 Oconnor RD
- Mailing City
- Fairport
- Mailing State
- NY
- Mailing ZIP Code
- 14450-1327
- Mailing Country
- US
- Mailing Phone
- (585) 377-4660
- Practice Street Address
- 41 Oconnor RD
- Practice City
- Fairport
- Practice State
- NY
- Practice ZIP Code
- 14450-1327
- Practice Country
- US
- Practice Phone
- (585) 377-4660
- Enumeration Date
- October 23, 2012
- Last Updated
- October 04, 2021
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- October 04, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Speech-Language Pathologist (235Z00000X), Speech-Language Pathologist (235Z00000X)
- Other Identifiers
- 03669174 (NY)