Costello, Kevin Robert

Costello, Kevin Robert is an individual health care provider with primary practice located at 458 Old Street Rd Suite 200, Peterborough NH 03458-1265. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Costello, Kevin Robert can be contacted via phone (603) 924-2144.

Contact Information

Primary practice address
458 Old Street Rd Suite 200 Peterborough NH 03458-1265
Phone: (603) 924-2144
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X

Profile Details

NPI number 1861441545
LBN Legal business name Costello, Kevin Robert
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date May 9th, 2006
Last updated Apr 16th, 2012 - about 13 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 1861441545 NPPES
New Hampshire MEDICAID 30338176
New Hampshire Other 0017075

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