Dana M. Costello, Pediatric Physical Therapy, LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

40QA00907700 Issued in NJ

Legal business name

DANA M. COSTELLO, PEDIATRIC PHYSICAL THERAPY, LLC

Practice address

501 Julie CT
Wyckoff, NJ 07481-1100

Phone

(973) 204-3491

Fax

(201) 891-1344

NPI assigned

Oct 14, 2009

Last updated

Oct 14, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Dana M. Costello

Title

Owner

Phone

(973) 204-3491

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1255478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255478400000",
    "number": "1467787101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 JULIE CT",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074811100",
            "telephone_number": "973-204-3491",
            "fax_number": "201-891-1344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 JULIE CT",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074811100",
            "telephone_number": "973-204-3491",
            "fax_number": "201-891-1344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANA M. COSTELLO, PEDIATRIC PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-14",
        "last_updated": "2009-10-14",
        "status": "A",
        "authorized_official_last_name": "COSTELLO",
        "authorized_official_first_name": "DANA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-204-3491",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NJ",
            "license": "40QA00907700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyler D'Agostino
• Patricia D'Amato
• Michael Christopher D'Arienzo, D.C.
• Michael John D'Arienzo, D.C.
• Emily Dalvano, M.A., CCC-SLP
• Jasmine Daniels, NP
• David J. Gallina, MD, PA
• David Yorio DO (Wyckoff Family Medicine)
• Jonathan Davis
• DBG Counseling

• Physical Medicine & Rehabilitation Physician in Wyckoff, NJ
• Providers in Wyckoff, NJ by specialty
• Physical Medicine & Rehabilitation Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.