Individual
KENT JAMES COSTELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
195 PLEASANT ST UNIT 5, BRADFORD, PA 16701-1081
(814) 362-5701
(814) 362-5702
Mailing address
908 NIAGARA FALLS BLVD STE 208, NORTH TONAWANDA, NY 14120-2019
(716) 799-1463
(833) 953-2016
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
025316
NY
363A00000X
Physician Assistant
Primary
MA061922
PA
Other
Enumeration date
10/26/2018
Last updated
06/17/2025
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