MS. KELLY COSTELLO

Specialist

Active Individual
NPI: 1700653151

Practice Address

299 HALLOCK AVENUE
Port Jefferson, NY 11776

Phone: (540) 532-8002

Specialties

Specialty Code Primary License
Specialist 174400000X Yes -

Frequently Asked Questions

NPI 1700653151 is the National Provider Identifier for MS. KELLY COSTELLO, a Specialist provider located in Port Jefferson, NY. This NPI was enumerated on December 6, 2023.
MS. KELLY COSTELLO practices at 299 HALLOCK AVENUE, Port Jefferson, NY 11776.

Quick Facts

NPI
1700653151
Type
Individual
Enumerated
Dec 6, 2023
Last Updated
Dec 6, 2023

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