Provider Demographics
NPI:1679565097
Name:KOSTO, BERNARD (MD)
Entity type:Individual
Prefix:
First Name:BERNARD
Middle Name:
Last Name:KOSTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:85 SEYMOUR ST
Mailing Address - Street 2:SUITE 416
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-5501
Mailing Address - Country:US
Mailing Address - Phone:860-947-8500
Mailing Address - Fax:860-524-8643
Practice Address - Street 1:85 SEYMOUR ST
Practice Address - Street 2:SUITE 416
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-5501
Practice Address - Country:US
Practice Address - Phone:860-947-8500
Practice Address - Fax:860-524-8643
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT011628208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT0S0307OtherHEALTH NET
CTP888603OtherOXFORD
CT001116284Medicaid
MA3164888Medicaid
CT0031969 002OtherCIGNA
CT06-1406459OtherCOLONIAL COOPERATIVE CARE
CT06-1406459OtherCORVEL
CT06-1406459OtherHMC, PPO
CT13666OtherHEALTH NEW ENGLAND
CT010011628CT01OtherANTHEM BCBS
CT06-1406459OtherMULTIPLAN
CT06-1406459OtherPRIVATE HEALTHCARE SYSTEM
CT096089OtherCONNECTICARE
CT06-1406459OtherFOCUS
CT06-1406459OtherUNITED HEALTHCARE
CT06-1406459OtherGREAT WEST HEALTHCARE
CT2054534OtherAETNA
CT13666OtherHEALTH NEW ENGLAND
CT096089OtherCONNECTICARE