Costello, John E
Costello, John E is an sole proprietor health care provider with primary practice located at 217 N Aurora St , Ithaca NY 14850-4345. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Costello, John E 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:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 149867 | New York |
Profile Details
| NPI number | 1871589267 |
|---|---|
| LBN Legal business name | Costello, John E |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 21st, 2005 |
| Last updated | Apr 30th, 2008 - about 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871589267 | NPPES |
| New York | MEDICAID | 00715224 | |
| New York | Other | 4217992 | |
| New York | Other | 000910795001 |
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