National Provider Identifier
Stacey M Costich, OTA
Stacey M Costich, OTA is listed in the NPPES registry with a primary specialty of Occupational Therapy Assistant in Medina, NY and a listed phone number of (585) 721-1241.
Profile Overview
- NPI
- 1497905251
- Provider Type
- Individual
- Primary Specialty
- Occupational Therapy Assistant
- Enumeration Date
- September 29, 2008
- Last Updated
- February 21, 2020
Practice Location
- 12005 Telegraph RD
- Medina, NY 14103-9678
Phone: (585) 721-1241
Mailing Address
- 590 Fishers Station Dr Ste 130
- Victor, NY 14564-9744
Specialties
- Occupational Therapy Assistant (224Z00000X)
- Specialist (174400000X)
Full Record
- NPI
- 1497905251
- Entity Type
- Individual
- Last Name
- Costich
- First Name
- Stacey
- Middle Name
- M
- Credential
- OTA
- Mailing Street Address
- 590 Fishers Station Dr Ste 130
- Mailing City
- Victor
- Mailing State
- NY
- Mailing ZIP Code
- 14564-9744
- Mailing Country
- US
- Mailing Phone
- (585) 924-7207
- Practice Street Address
- 12005 Telegraph RD
- Practice City
- Medina
- Practice State
- NY
- Practice ZIP Code
- 14103-9678
- Practice Country
- US
- Practice Phone
- (585) 721-1241
- Enumeration Date
- September 29, 2008
- Last Updated
- February 21, 2020
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- February 21, 2020
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Occupational Therapy Assistant (224Z00000X), Specialist (174400000X)