Individual
AMANDA COSTELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
267 GRANT ST, BRIDGEPORT, CT 06610-2805
(203) 384-4677
(203) 384-3135
Mailing address
20 YORK STREET, CB-329, NEW HAVEN, CT 06510-3220
(203) 688-1734
(203) 384-3135
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
7888
CT
Other
Enumeration date
10/12/2018
Last updated
12/19/2019
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