Costello, Laurie J.
Costello, Laurie J. is an individual health care provider with primary practice located at 180 E Pulaski Rd , Huntington Station NY 11746-1915. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Costello, Laurie J. can be contacted via phone (631) 425-2121.Contact Information
Primary practice address
180 E Pulaski Rd
Huntington Station NY 11746-1915
Phone: (631) 425-2121
Fax: (631) 425-2193
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 191191-1 | New York |
Profile Details
| NPI number | 1376540435 |
|---|---|
| LBN Legal business name | Costello, Laurie J. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 5th, 2005 |
| Last updated | Feb 25th, 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 | 1376540435 | NPPES |
| New York | MEDICAID | 01592465 |
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