Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jack Emanuel Costas Jr.

Individual provider Registered Nurse · NPI 1649840372

Jack Emanuel Costas Jr. is a Registered Nurse in Shoreham, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2021

Practice location Address checks out

9 The Bnd
Shoreham, NY 11786-2239
Phone: (516) 787-2405
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Nurse (primary) Taxonomy 163W00000X · Licence 798819-01 (NY)

Record details

NPI number1649840372
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJune 25, 2021
Last updated in NPPESJune 25, 2021
Certification dateJune 25, 2021

Other providers in Shoreham