National Provider Identifier
John E Costello, MD
John E Costello, MD is listed in the NPPES registry with a primary specialty of Internal Medicine Physician in Ithaca, NY and a listed phone number of (607) 273-2811.
Profile Overview
- NPI
- 1871589267
- Provider Type
- Individual
- Primary Specialty
- Internal Medicine Physician
- Enumeration Date
- September 21, 2005
- Last Updated
- April 30, 2008
Practice Location
- 217 N Aurora St
- Ithaca, NY 14850-4345
Phone: (607) 273-2811
Specialties
- Internal Medicine Physician (207R00000X)
Full Record
- NPI
- 1871589267
- Entity Type
- Individual
- Last Name
- Costello
- First Name
- John
- Middle Name
- E
- Credential
- MD
- Mailing Street Address
- 217 N Aurora St
- Mailing City
- Ithaca
- Mailing State
- NY
- Mailing ZIP Code
- 14850-4345
- Mailing Country
- US
- Mailing Phone
- (607) 273-2811
- Mailing Fax
- (607) 273-1170
- Practice Street Address
- 217 N Aurora St
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-4345
- Practice Country
- US
- Practice Phone
- (607) 273-2811
- Practice Fax
- (607) 273-1170
- Enumeration Date
- September 21, 2005
- Last Updated
- April 30, 2008
- Sex
- Male
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Internal Medicine Physician (207R00000X)
- Other Identifiers
- 00715224 (NY), 4217992 (Aetna), 000910795001 (Healthnow)