Individual
EILEEN A. COSTELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
56 45 MAIN STREET, W-LL300, FLUSHING, NY 11355-5045
(718) 670-1185
(718) 670-2312
Mailing address
56 45 MAIN STREET, W-LL300, FLUSHING, NY 11355-5045
(718) 670-2127
(347) 328-9362
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F338319
NY
363LF0000X
Family Nurse Practitioner
F338319-1
NY
Other
Enumeration date
09/26/2013
Last updated
06/06/2023
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