Costelloe, Luisa M

Costelloe, Luisa M is an individual health care provider with primary practice located at 40-16 Astoria Blvd , Long Island City NY 11103. She recently has only one registered license in Dental Providers / Dentist, which is considered as her primary health care specialty. Costelloe, Luisa M can be contacted via phone (718) 937-3836.

Contact Information

Primary practice address
40-16 Astoria Blvd Long Island City NY 11103
Phone: (718) 937-3836
Fax: (718) 937-3836
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 044783 Puerto Rico
Dental Providers / Dentist 122300000X 044783 New York

Profile Details

NPI number 1912099730
LBN Legal business name Costelloe, Luisa M
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 29th, 2006
Last updated Sep 22nd, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912099730 NPPES
New York MEDICAID 01432062

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