Costello, Ann R

Costello, Ann R is an sole proprietor health care provider with primary practice located at 217 N Aurora St , Ithaca NY 14850-4345. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Geriatric Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Costello, Ann R can be contacted via phone (607) 273-2811.

Contact Information

Primary practice address
217 N Aurora St Ithaca NY 14850-4345
Phone: (607) 273-2811
Fax: (607) 273-1170
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X 149866 New York
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 149866 New York

Profile Details

NPI number 1235125626
LBN Legal business name Costello, Ann R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 21st, 2005
Last updated Jan 24th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235125626 NPPES
New York Other 000910796001 HEALTHNOW
New York MEDICAID 00715215 HEALTHNOW
New York Other 4217986 HEALTHNOW

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