Ann R Costello
NPI #1144635087 in Ithaca, New York
Provider Information
- NPI Number
- 1144635087
- Entity Type
- Organization
- Organization Name
- Ann R Costello
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- MEDVANTX, INC.
- Primary Specialty
- Non-Pharmacy Dispensing Site
- Enumeration Date
- Jun 30, 2014
- Last Updated
- Jan 13, 2017
Practice Location
Authorized Official
- Name
- SCOTT PETERSON
- Title
- CFO
- Phone
- (858) 625-2990
Specialties & Taxonomy Codes
| Specialty |
|---|
| Non-Pharmacy Dispensing Site |
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