REGINA M COSTROFF (NPI# 1932670486) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932670486 |
| Entity Type | Individual |
| Full Name | REGINA M COSTROFF |
| Credential | PA-C |
| Practice Address |
630 Mantua Pike Woodbury NJ 08096 |
| Mailing Address |
5000 Cox Rd Glen Allen VA 23060-9263 |
| Practice Telephone | 8568122220 |
| Mailing Telephone | 8049685700 |
| Enumeration Date | 2018-12-10 |
| Last Update Date | 2019-06-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 25MP0050660 | NJ | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | C5-0001277 | DE | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4755 Ogletown Stanton Rd Ste 2670, Newark, DE 197182200 | 3025842601 |
| Street Address |
630 MANTUA PIKE |
| City | WOODBURY |
| State | NJ |
| Zip Code | 08096 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083663769 | Joseph Louis Granito | Emergency Medicine | 630 Mantua Pike, Woodbury, NJ 08096-3233 | 2006-05-09 |
| 1689021842 | Christen Denise Ground | Family Medicine | 630 Mantua Pike, Woodbury, NJ 08096-3233 | 2016-05-18 |
| 1336538701 | Patient First Maryland Physician Group, P.C. | Non-Pharmacy Dispensing Site | 630 Mantua Pike, Woodbury, NJ 08096-3233 | 2015-01-22 |
| 1609280999 | Patient First Maryland Physicians Group, P.C. | Family Medicine | 630 Mantua Pike, Woodbury, NJ 08096-3233 | 2014-06-16 |
| 1225373111 | Adriana Davis | Family Medicine | 630 Mantua Pike, Woodbury, NJ 08096-3233 | 2012-12-03 |
| 1548524838 | Patrick Antonio | Family Medicine | 630 Mantua Pike, Woodbury, NJ 08096-3233 | 2012-07-02 |
| 1699077909 | Fern Elyse Kopp Mulberg | Family Medicine | 630 Mantua Pike, Woodbury, NJ 08096-3233 | 2010-11-19 |
| 1104007285 | Scott Matthew Edmondson | Physician Assistant | 630 Mantua Pike, Woodbury, NJ 08096-3233 | 2007-11-17 |
| 1689698813 | Nancy A. Bierman-dear | Family Medicine | 630 Mantua Pike, Woodbury, NJ 08096-3233 | 2006-07-27 |
| 1891737722 | Dale Norman Goode | Emergency Medicine | 630 Mantua Pike, Woodbury, NJ 08096-3233 | 2006-06-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780226043 | Assoc. for Retarded Citizens, Inc. Gloucester County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1460 Cooper Street, Deptford, NJ 08096 | 2019-10-08 |
| 1730652058 | Robert Crawford Counseling & Consultation, LLC | Counselor | Robert Crawford Counseling & Consultation, LLC, 44 Cooper Street, Suite 208, Woodbury, NJ 08096 | 2019-01-09 |
| 1902381171 | Services To Overcome Drug Abuse Among Teenagers, Inc. | Clinic/Center | 124 N Broad Street, Woodbury, NJ 08096 | 2018-10-03 |
| 1225518715 | Michael West | Pharmacist | 631 West Mantua Ave, Woodbury, NJ 08096 | 2018-08-15 |
| 1053807891 | Standing Ground Counseling, LLC | Clinic/Center | 44 Cooper Street, Suite 104, Woodbury, NJ 08096 | 2018-07-05 |
| 1376054536 | Assoc. for Retarded Citizens, Inc. Gloucester County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 40 Hessian Avenue, Woodbury, NJ 08096 | 2017-10-16 |
| 1881105021 | Assoc. for Retarded Citizens, Inc. Gloucester County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1154 Bennett Drive, Deptford, NJ 08096 | 2017-10-16 |
| 1215448469 | Assoc. for Retarded Citizens, Inc. Gloucester County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7 North Evergreen Avenue, Woodbury, NJ 08096 | 2017-10-16 |
| 1801307137 | Assoc. for Retarded Citizens, Inc. Gloucester County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6 North Drexel Street, Woodbury, NJ 08096 | 2017-10-13 |
| 1295253847 | Sara Alven | Social Worker | 1 Lupton Avenue, Woodbury, NJ 08096 | 2017-09-05 |
| Find all providers in zip 08096 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518587583 | Amy Marie Lyttle | Physician Assistant | 570 Settlers Ridge Pkwy Unit A305, Woodbury, MN 55129-7509 | 2020-04-20 |
| 1104338730 | Elissa Fung | Physician Assistant | 779 Bielenberg Dr Ste 108, Woodbury, MN 55125-4432 | 2017-11-05 |
| 1417253212 | Sara Lynn Sterling | Physician Assistant | 217 Radio Dr, Woodbury, MN 55125-5805 | 2011-01-27 |
| 1639486434 | Ariana Zaza | Physician Assistant | 1 2nd St, Woodbury, NY 11797-1310 | 2010-09-01 |
| 1508047127 | Anna E. Ng | Physician Assistant | 17 W Red Bank Ave Ste 205, Woodbury, NJ 08096-1630 | 2007-11-26 |
| 1033399886 | Kristen D Ballenthin | Physician Assistant | 449 Commerce Drive, Woodbury, MN 55125-4872 | 2007-11-09 |
| 1104852094 | Kaitlin Buckner | Physician Assistant | 6043 Hudson Rd Ste 220, Woodbury, MN 55125-1033 | 2006-06-23 |
| 1972540573 | Susan A Murray | Physician Assistant | 1687 Woodlane Dr Ste 103, Woodbury, MN 55125-3046 | 2006-06-01 |
| 1518911247 | Deborah Lee Hinkle | Physician Assistant | Stones River Hospital, 324 Doolittle Road, Woodbury, TN 37190-5041 | 2006-05-19 |
| 1013986611 | Jennifer Susan Ellis | Physician Assistant | 4040 Radio Dr, Woodbury, MN 55129-3237 | 2006-03-16 |
| Find all providers in WOODBURY | ||||
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| 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.