1629414313 NPI number — DR. RICHARD DONALD COSTER D.C.

Table of content: DR. RICHARD DONALD COSTER D.C. (NPI 1629414313)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629414313 NPI number — DR. RICHARD DONALD COSTER D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COSTER
Provider First Name:
RICHARD
Provider Middle Name:
DONALD
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
M

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:
1629414313
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/13/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
767 MINERAL SPRINGS RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEST SENECA
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14224-1053
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-982-3134
Provider Business Mailing Address Fax Number:
716-823-2113

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2839 ELMWOOD AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KENMORE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14217-1330
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-955-0993
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/21/2013

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: 111N00000X , with the licence number:  X012348 , 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)





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