Individual
KATHLEEN TERESA COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.AC
Contact information
Practice address
1239 N COUNTRY RD STE 3, STONY BROOK, NY 11790-1920
(631) 601-6491
Mailing address
1239 N COUNTRY RD STE 3, STONY BROOK, NY 11790-1920
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
007122
NY
Other
Enumeration date
01/11/2023
Last updated
01/11/2023
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