| Provider / Organization | NPI | Date Certified |
|---|---|---|
| ALICE MARY COSTELLO | 1982203360 | 2020-10-18 |
Alice Mary Costello is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1982203360. Registration indicates Alice Mary Costello is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Nurse Practitioner: Family, ) (All Other Specialties & Provider Types, ) (Nurse Practitioner Family, Physician Assistants & Advanced Practice Nursing Providers) (Nurse Practitioner, ) Access to Adult/Geriatric Primary Care Providers (Allopathic & Osteopathic Physicians, Family Medicine) Access to Pediatric Primary Care Providers (Allopathic & Osteopathic Physicians, Family Medicine) (Allopathic & Osteopathic Physicians, Family Medicine) (Family Medicine, ) (Primary Care/Family Planning/APRN/PA, ) (Family Medicine, Allopathic & Osteopathic Physicians)
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Alice Mary Costello FNP |
| Practice Office Address | 10 S POINTE LNDG STE 250 ROCHESTER, NY US |
| Practice Office Telephone | 5854264084 |
| Practice Office Fax | 5854264631 |
| Mailing Address | 10 S POINTE LNDG STE 250 ROCHESTER, NY 146063483 US |
| Business Telephone | 5854264084 |
| Business Fax | 5854264631 |
| Direct Messaging Address [OTHER] | [email protected] | Direct |
| Code | Practice | License No State |
|---|---|---|
| 363LF0000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse PractitionerAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Nurse Practitioner: Family All Other Specialties & Provider Types Nurse Practitioner Family Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | 345596
NY |
| 207Q00000X | Access to Adult/Geriatric Primary Care Providers Allopathic & Osteopathic Physicians Family MedicineAccess to Pediatric Primary Care Providers Allopathic & Osteopathic Physicians Family Medicine Allopathic & Osteopathic Physicians Family Medicine Family Medicine Primary Care/Family Planning/APRN/PA Family Medicine Allopathic & Osteopathic Physicians | F345596
NY |