Individual
MR. MARTIN COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
526 PENN ST, READING, PA 19602-1096
(610) 375-7740
(610) 898-1149
Mailing address
526 PENN ST, READING, PA 19602-1096
(610) 375-7740
(610) 898-1149
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA001312L
PA
Other
Enumeration date
02/24/2009
Last updated
02/24/2009
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