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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MS. KELLY JO COSTELLO

Active Sole Proprietor

MS. KELLY JO COSTELLO is a Specialist healthcare provider located in PORT JEFFERSON, New York. NPI 1700653151 is currently active in the NPPES registry. Verify at CMS.

Specialist · PORT JEFFERSON, NY

Registration Details

NPI Number
1700653151
Provider Type
Individual
Gender
Female
NPI Issued
Dec 6, 2023 (2.6780103702329 yrs)
Last Updated
Dec 6, 2023
Sole Proprietor
Yes

Practice Information

Address
299 HALLOCK AVENUE
PORT JEFFERSON, NY, 11776
Browse NY providers · Browse ZIP 11776
Phone
5405328002
Primary Specialty
Specialist
174400000X

Other Specialist Providers in PORT JEFFERSON, NY

Name Credential NPI
DR. MORTON L GLASER MD 1487657755
AJAY V. BERDIA M.D. 1801891908
MR. SALIM A MATAR MD 1609891571
DR. YVON DAMOUR M.D. 1124114491
MR. PHILIP JOSEPH CELESTINO C.PED. 1659493575
MS. PAMELA CADEN 1063707339
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.