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Organization

EASTERN REGIONAL PAIN MANAGEMENT, P.C.

Active
Other names
Thomas P Costello DO
Organization subpart
No

Provider details

NPI number
Authorized official
DR. THOMAS P COSTELLO DO (PRESIDENT)
(215) 953-8882
Entity
Organization

Contact information

Practice address
4979 OLD STREET RD, SUITE 1A, TREVOSE, PA 19053-6222
(215) 953-8882
(215) 953-8822
Mailing address
4979 OLD STREET RD, SUITE A, TREVOSE, PA 19053-6222
(215) 953-8882
(215) 953-8822

Taxonomy

Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
MB50806
NJ
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
OS005840L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2006338000
IBC
PA
Enumeration date
04/26/2006
Last updated
02/20/2012
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