Individual
JOSEPH J. COSTELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
45 N MAIN ST, SUITE 1, PITTSTON, PA 18640-1915
(570) 654-4641
(570) 654-4642
Mailing address
45 N MAIN ST, SUITE 1, PITTSTON, PA 18640-1915
(570) 654-4641
(570) 654-4642
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC003054L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010811390003
—
PA
01
—
3610
GEISINGER HEALTH PLAN
PA
01
—
475671
PA BLUE SHIELD
PA
01
—
817167
FIRST PRIORITY
PA
01
—
P00002482
RAILROAD MEDICARE
—
Enumeration date
03/16/2006
Last updated
05/03/2012
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