Most Relevant Information
Provider Data
| NPI Number: | 1003361171 |
| Provider Name: | COSTNER MCKENZIE MD |
| Entity Type: | Individual |
| Taxonomy Code: | 207R00000X |
| Specialty: | Internal Medicine |
| License Number: | 125.076103 |
Most Important Dates
| Enumeration Date: | 08/18/2016 |
| Last Updated: | 06/24/2021 |
Provider Practice Location
550 1ST AVE
NEW YORK
NY
100166402
Practice Location Phone/Fax
| Phone: | 8475702000 |
| Fax: |
Provider Mailing Location
550 1ST AVE
NEW YORK
NY
100166402
Provider Mailing Phone/Fax
| Phone: | 2122635506 |
| Fax: |
Suggested EMR
Internist EMR