Individual
MICHAEL COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
1 CONVENTION AVE, PHILADELPHIA, PA 19104-4311
(215) 662-4000
Mailing address
26 RADNOR BLVD, MARLTON, NJ 08053-2316
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
SP030589
PA
Other
Enumeration date
09/20/2024
Last updated
09/20/2024
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