Individual
MRS. ELIZABETH MAREN COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1990 DOVER RD, SUITE 201, EPSOM, NH 03234-4146
(603) 736-6200
(603) 736-6220
Mailing address
1990 DOVER RD, SUITE 201, EPSOM, NH 03234-4146
(603) 736-6200
(603) 736-6220
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0982
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3091378
—
NH
Enumeration date
10/04/2013
Last updated
12/15/2015
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