Individual
VICTORIA WALKER COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
263 FARMINGTON AVE, FARMINGTON, CT 06030-0001
(860) 679-8400
(860) 679-8188
Mailing address
263 FARMINGTON AVE, FARMINGTON, CT 06030-8020
(860) 679-8400
(860) 679-8188
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01066714A
IN
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
54555
CT
208M00000X
Hospitalist Physician
01066714A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200959610
—
IN
Enumeration date
01/29/2007
Last updated
09/20/2022
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