Costello, Sr., John J.
Costello, Sr., John J. is an sole proprietor health care provider with primary practice located at 131 Main St Suite 202, Oneida NY 13421-1641. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Costello, Sr., John J. can be contacted via phone (315) 363-4942.Contact Information
Primary practice address
131 Main St Suite 202
Oneida NY 13421-1641
Phone: (315) 363-4942
Fax: (315) 363-4441
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | TUV002717-1 | New York |
Profile Details
| NPI number | 1245309970 |
|---|---|
| LBN Legal business name | Costello, Sr., John J. |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 7th, 2006 |
| Last updated | Jan 14th, 2014 - about 10 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 | 1245309970 | NPPES |
| New York | MEDICAID | 02961255 |
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