Organization
DANA M. COSTELLO, PEDIATRIC PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANA M. COSTELLO (OWNER)
(973) 204-3491
Entity
Organization
Contact information
Practice address
501 JULIE CT, WYCKOFF, NJ 07481-1100
(973) 204-3491
(201) 891-1344
Mailing address
501 JULIE CT, WYCKOFF, NJ 07481-1100
(973) 204-3491
(201) 891-1344
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
40QA00907700
NJ
Other
Enumeration date
10/14/2009
Last updated
10/14/2009
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