National Provider Identifier
Michael John Costello, PT
Michael John Costello, PT is listed in the NPPES registry with a primary specialty of Orthopedic Physical Therapist in Ithaca, NY and a listed phone number of (607) 252-3500.
Profile Overview
- NPI
- 1649593211
- Provider Type
- Individual
- Primary Specialty
- Orthopedic Physical Therapist
- Enumeration Date
- March 10, 2010
- Last Updated
- March 10, 2010
Practice Location
- 310 Taughannock Blvd
- Ithaca, NY 14850-3251
Phone: (607) 252-3500
Specialties
- Orthopedic Physical Therapist (2251X0800X)
Full Record
- NPI
- 1649593211
- Entity Type
- Individual
- Last Name
- Costello
- First Name
- Michael
- Middle Name
- John
- Credential
- PT
- Mailing Street Address
- 310 Taughannock Blvd
- Mailing City
- Ithaca
- Mailing State
- NY
- Mailing ZIP Code
- 14850-3251
- Mailing Country
- US
- Mailing Phone
- (607) 252-3500
- Mailing Fax
- (607) 252-3505
- Practice Street Address
- 310 Taughannock Blvd
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-3251
- Practice Country
- US
- Practice Phone
- (607) 252-3500
- Practice Fax
- (607) 252-3505
- Enumeration Date
- March 10, 2010
- Last Updated
- March 10, 2010
- Sex
- Male
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Orthopedic Physical Therapist (2251X0800X)
- Other Identifiers
- 22-2325405 (NY, Employer Federal Tax Identification Cayuga Medical Center At Ithaca), 00332729 (NY)