Individual
DR. JOSEPH THOMAS COSTELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
50 SEQUAMS LN W, WEST ISLIP, NY 11795-4527
(631) 669-8230
Mailing address
50 SEQUAMS LN W, WEST ISLIP, NY 11795-4527
(631) 669-8230
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
009827
NY
Other
Enumeration date
04/04/2013
Last updated
04/04/2013
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