Individual
MS. CHRISTINE JUNE COSTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
270 PARK AVE, HUNTINGTON, NY 11743-2787
(631) 547-6392
Mailing address
PO BOX 415661, BOSTON, MA 02241-5661
(631) 547-6392
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F304648-1
NY
Other
Enumeration date
10/07/2008
Last updated
04/24/2014
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