Individual
LISA COSTELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
100 K JOHNSON BLVD N., 2ND FLOOR, BORDENTOWN, NJ 08505
(609) 528-8884
Mailing address
100 K JOHNSON BLVD N., 2ND FLR, BORDENTOWN, NJ 08505-2275
(609) 528-8884
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NJ00900700
NJ
Other
Enumeration date
04/04/2019
Last updated
04/26/2021
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