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NPI Profile for KEVIN R COSTELLO in PETERBOROUGH, NH.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Surgical |
363AS0400X | 97 | Physician Assistant |
| NPI Number | 1861441545 |
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| Status | Active | |
| Credentials | PA (Physician Assistant) | |
| Entity | Individual | |
| Enumeration date | 05/09/2006 | |
| Last updated | 04/16/2012 - About 14 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
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| Hospital affiliation(s) |
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KEVIN R COSTELLO
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KEVIN R COSTELLO, PA