Organization · Type 2 NPI
Thomas E. Costello, Md, Pt, PLLC
Primary Care Clinic/Center · Dix Hills, NY
NPI number
1811367402
Active
Practice location
14 Villanova Ln
Dix Hills, NY 11746-4841
Mailing address
PO Box 464
Huntington Station, NY 11746-0374
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physical Therapy Clinic/Center | 261QP2000X | 011915 (NY) |
| Primary Care Clinic/Center Primary | 261QP2300X | 267336 (NY) |
Primary Care Clinic/Center: Definition to come...
About NPI 1811367402
Thomas E. Costello, Md, Pt, PLLC's National Provider Identifier is 1811367402, issued on Sep 25, 2015. The primary taxonomy on file is Primary Care Clinic/Center (261QP2300X), and the practice location is in Dix Hills, NY. The record was last updated on Mar 14, 2023.