1114113842 NPI number — KATHLEEN COSTELLO BAR-TUR LCSW

Table of content: KATHLEEN COSTELLO BAR-TUR LCSW (NPI 1114113842)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114113842 NPI number — KATHLEEN COSTELLO BAR-TUR LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COSTELLO BAR-TUR
Provider First Name:
KATHLEEN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114113842
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/04/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15 W 72ND ST
Provider Second Line Business Mailing Address:
SUITE 1E
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10023-3402
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-866-0489
Provider Business Mailing Address Fax Number:
212-865-0449

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15 W 72ND ST
Provider Second Line Business Practice Location Address:
SUITE 1E
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10023-3402
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-866-0489
Provider Business Practice Location Address Fax Number:
212-865-0449
Provider Enumeration Date:
09/17/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  R052085-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com