Individual
JOHN COSTELLO
Active
Individual
JOHN COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
217260
MA
2080P0202X
Pediatric Cardiology Physician
52686
SC
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
52686
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2014416
—
MA
01
—
25-01706
UNITED HEALTHCARE MA
MA
01
—
26528
BMC HEALTHNET
MA
01
—
32292
NEIGHBORHOOD HEALTH PLAN
MA
01
—
3253447
AETNA MA
MA
01
—
97288001
NETWORK HEALTH
MA
01
—
AA9211
HARVARD PILGRIM
MA
01
—
J26530
HMO BLUE
MA
05
—
JC51504
—
RI
01
—
TUFTS HEALTH PLAN
217260
MA
Enumeration date
10/31/2005
Last updated
02/18/2022
Update your record
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