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Organization
COSTELLO EYE PHYSICIANS & SURGEONS, PLLC
Active
Organization
COSTELLO EYE PHYSICIANS & SURGEONS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN J COSTELLO JR. DO (PARTNER)
(315) 363-1110
Entity
Organization
Contact information
Practice address
578 SENECA ST, ONEIDA, NY 13421-2600
(315) 363-1110
(315) 363-4441
Mailing address
1001 W FAYETTE ST, SUITE 400, SYRACUSE, NY 13204-2859
(315) 472-1488
(315) 472-1488
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
NULL
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
NULL
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02887589
—
NY
Enumeration date
08/09/2006
Last updated
07/15/2008
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