Individual
ADRIAN COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1167 NOSTRAND AVE, BROOKLYN, NY 11225-5417
(718) 778-0198
(718) 221-8169
Mailing address
60 MADISON AVE, 5TH FLOOR, NEW YORK, NY 10010-1600
(212) 545-2438
(646) 312-0481
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
083805-1
NY
1041C0700X
Clinical Social Worker
Primary
083146-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00695941
—
NY
Enumeration date
01/23/2015
Last updated
05/22/2015
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