Individual
MS. ANTONIA COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1 GUSTAVE L LEVY PLACE, BOX 1252-MOUNT SINAI HOSPITAL, NEW YORK, NY 10029-6574
(212) 241-1764
Mailing address
1 JACKSON SQ, JERSEY CITY, NJ 07305-3499
(012) 547-6806
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
074030
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
126697
SCREEN
NY
Enumeration date
12/27/2007
Last updated
08/16/2022
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