Individual
ALYSSA COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4250 SUNRISE HWY, MASSAPEQUA, NY 11758-5338
(516) 654-9090
Mailing address
1110 LAKESHORE DR, MASSAPEQUA PARK, NY 11762-2010
(516) 965-7399
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
07/21/2022
Last updated
07/21/2022
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