DR. ELENE JESSICA COSTUCK (NPI# 1740318039) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740318039 |
| Entity Type | Individual |
| Full Name | DR. ELENE JESSICA COSTUCK |
| Credential | PH.D. |
| Practice Address |
168 Hill St Southampton NY 11968-5310 |
| Mailing Address |
492 N Main St # 2 Southampton NY 11968-2804 |
| Practice Telephone | 6312833356 |
| Mailing Telephone | 6317266494 |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
015628-1 | NY | Behavioral Health & Social Service Providers |
| Street Address |
168 HILL ST |
| City | SOUTHAMPTON |
| State | NY |
| Zip Code | 11968-5310 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396343786 | Veronica Ellen Kyrk | Speech-Language Pathologist | 168 Hill St, Southampton, NY 11968-5337 | 2020-10-16 |
| 1134732134 | Stephanie Nicole Mueller | Specialist | 168 Hill St, Southampton, NY 11968-5337 | 2020-08-28 |
| 1386298818 | Brooke Ann Halloran | Specialist | 168 Hill St, Southampton, NY 11968-5337 | 2019-08-01 |
| 1720552961 | Diana Dautzenberg | Speech-Language Pathologist | 168 Hill St, Southampton, NY 11968-5337 | 2019-01-21 |
| 1275042962 | Cassandra Leigh Rooney | Specialist/Technologist | 168 Hill St, Southampton, NY 11968-5337 | 2017-09-25 |
| 1487190021 | Deborah Edelman | Social Worker | 168 Hill St, Southampton, NY 11968-5337 | 2017-01-06 |
| 1851754048 | Diana Unger | Early Intervention Provider Agency | 168 Hill St, Southampton, NY 11968-5337 | 2016-04-04 |
| 1205297686 | Amanda Schulz | Speech-Language Pathologist | 168 Hill St, Southampton, NY 11968-5337 | 2016-03-14 |
| 1164853974 | Dorothy Walker | Specialist | 168 Hill St, Southampton, NY 11968-5337 | 2013-12-04 |
| 1922243575 | Sue Mckenna | Occupational Therapist | 168 Hill St, Southampton, NY 11968-5310 | 2008-12-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992333553 | Adam Spinner | Student in an Organized Health Care Education/Training Program | Stony Brook Southampton General Surgery, 240 Meeting House Lane, Southampton, NY 11968 | 2020-03-30 |
| 1538725205 | Blossom Counseling Services | Clinic/Center | 225 Old Point Rd, Southampton, NY 11968 | 2019-05-17 |
| 1386184679 | Oscar F. Mandes | Social Worker | 57 Hampton Road, Suite 201, Southampton, NY 11968 | 2017-03-06 |
| 1346780046 | Jacqueline Chantal Rosante | Physician Assistant | Meeting House Lane Medical Practice, PC Surgical Spec., 240, Southampton, NY 11968 | 2017-02-28 |
| 1316377260 | Empire Osteopathy LLC | Neuromusculoskeletal Medicine & OMM | 332a Canoe Place Road, Southampton, NY 11968 | 2013-11-13 |
| 1619225984 | Elizabeth Hope Piselli | Podiatrist | 365 County Road 39a Unit 9, Southampton, NY 11968 | 2012-08-16 |
| 1902164965 | University Hospital At Stony Brook | Clinic/Center | Church Street, Southampton, NY 11968 | 2012-04-27 |
| 1588933170 | Lindsey Dargan | Speech-Language Pathologist | 141 Narrow Lane, Southampton, NY 11968 | 2011-12-28 |
| 1013249069 | Justina Savarese | Speech-Language Pathologist | 168 Hill Street, Southampton, NY 11968 | 2010-02-02 |
| 1164541918 | Maria Radu | Dentist | 39 Inlet Rd East, Southampton, NY 11968 | 2007-03-29 |
| Find all providers in zip 11968 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336621762 | Tina Marie Gonzales | Psychologist | 928 Jaymor Road Suite B-150, Southampton, PA 19040 | 2018-09-01 |
| 1174780258 | Joseph G. Rosenfeld | Psychologist | 43 Springwood Dr, Southampton, PA 18966-3054 | 2008-05-17 |
| 1841339397 | Kathleen M. Dillon | Psychologist | 139 Fomer Rd, Southampton, MA 01073-9516 | 2007-02-05 |
| 1013926583 | Southampton Psychiatric Associates PC | Psychologist | 1111 Street Rd, Suite 312, Southampton, PA 18966-4250 | 2006-08-05 |
| 1811924038 | Fred Larry Dorfman | Psychologist | 707 Lakeside Park, Southampton, PA 18966-4020 | 2006-06-26 |
| 1275531634 | Steven R. Cohen | Psychologist | 967 Street Rd, Southampton, PA 18966-4728 | 2005-07-11 |
| 1285157172 | Jennifer Rebekah Nowak | Psychologist | 928 Jaymor Rd Ste B-150, Southampton, PA 18966-3853 | 2017-07-21 |
| 1104287564 | Lifespan Counseling Center LLC | Psychologist | 729 Grove Ave, Suite 3, Southampton, PA 18966-6008 | 2016-03-14 |
| 1417314758 | Deborah Meyrowitz Weiss LLC | Psychologist | 1111 Street Rd, Suite 101, Southampton, PA 18966-4250 | 2016-01-18 |
| 1063814283 | Megan Dufford | Psychologist | 928 Jaymor Rd Ste C-120, Southampton, PA 18966-3835 | 2014-09-18 |
| Find all providers in SOUTHAMPTON | ||||
| City | SOUTHAMPTON |
| Zip Code | 11968 |
Please comment or provide details below to improve the information on DR. ELENE JESSICA COSTUCK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.