Costello-Siri, Jennifer

Costello-Siri, Jennifer is an sole proprietor health care provider with primary practice located at 305 Winthrop Dr , Ithaca NY 14850-1736. She recently has 2 registered licenses in different health care specialties including Agencies / Early Intervention Provider Agency, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Costello-Siri, Jennifer can be contacted via phone (646) 318-2807.

Contact Information

Primary practice address
305 Winthrop Dr Ithaca NY 14850-1736
Phone: (646) 318-2807
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Agencies / Early Intervention Provider Agency 252Y00000X 076568-1 New York
Behavioral Health & Social Service Providers / Clinical 1041C0700X
Behavioral Health & Social Service Providers / Clinical 1041C0700X 081170-1 New York

Profile Details

NPI number 1053557298
LBN Legal business name Costello-Siri, Jennifer
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 17th, 2008
Last updated Oct 30th, 2013 - about 12 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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