Active NPI
Dolores Costello, N.P.
- Licensed Practical Nurse
- New York, NY
National Provider Identifier
1457419640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 430255
- Practice address
- 1111 Amsterdam Ave
New York, NY 10025-1716 - Phone
- (212) 523-4007
- Fax
- (212) 315-0196
- NPI assigned
- Dec 4, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 430255 | NY | Primary |
Addresses
Primary practice location
1111 Amsterdam Ave
New York, NY 10025-1716
Mailing address
1790 Broadway
3Rd Floor
New York, NY 10019-1412
Phone (212) 315-0144
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 430255 | Other | NY | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 430255 | NY | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192665600000",
"number": "1457419640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1790 BROADWAY",
"address_2": "3RD FLOOR",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100191412",
"telephone_number": "212-315-0144",
"fax_number": "212-315-0196"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 AMSTERDAM AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100251716",
"telephone_number": "212-523-4007",
"fax_number": "212-315-0196"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COSTELLO",
"first_name": "DOLORES",
"name_prefix": "Dr.",
"credential": "N.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-04",
"last_updated": "2007-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "NY",
"license": "430255",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "430255",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.