Individual
MR. BRIAN L. COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5310 HOMESTEAD RD NE, SUITE 301, ALBUQUERQUE, NM 87110-1437
(505) 872-4700
(505) 872-4709
Mailing address
5310 HOMESTEAD RD NE, SUITE 301, ALBUQUERQUE, NM 87110-1437
(505) 872-4700
(505) 872-4709
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
12/08/2005
Last updated
09/26/2016
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