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Ms. Kelly Jo Costello
Specialist in Port Jefferson, New York
NPI 1700653151

Kelly Jo Costello is a Specialist based in Smithtown, NY. Kelly Jo Costello practices in Port Jefferson, NY. The NPI Number for Kelly Jo Costello is 1700653151 and holds a License No. (New York).

The current practice location address for Kelly Jo Costello is 299 Hallock Avenue, Port Jefferson, NY and can be reached out via phone at 540-532-8002.

Location: 299 Hallock Avenue, Port Jefferson, NY, 11787-2804
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1700653151
Provider Name
Kelly Jo Costello
Credential
Provider Entity Type
Individual
Gender
Female
Address
299 Hallock Avenue, Port Jefferson, NY, 11787-2804
Phone Number
540-532-8002
Fax Number
Provider Enumeration Date
12/06/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
299 Hallock Avenue
City
Port Jefferson
State
New York
Zip
11776
Phone Number
540-532-8002
Fax Number
person
Provider Business Mailing Address Details
Address
299 Hallock Avenue
City
Port Jefferson
State
New York
Zip
11776
Phone Number
540-532-8002
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
()
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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