Individual
MR. MATTHEW D COSTELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
612 JILLIAN FRANCES CIR, PICKERINGTON, OH 43147-1566
(330) 550-5814
Mailing address
1675 W WESTERN RESERVE RD UNIT 9C, YOUNGSTOWN, OH 44514-4500
(330) 550-5814
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.418095
OH
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN.CRNA.0020479
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/30/2021
Last updated
09/26/2022
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