Antonio Costello
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Fostoria, OH
NPI 1609417302 · NPPES record last updated Oct 3, 2019
Key facts
- NPI
- 1609417302
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 2641 Brookside Dr
Fostoria, OH 44830-1304 - Phone
- (567) 207-0596
- NPI assigned
- Oct 3, 2019
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
2641 Brookside Dr
Fostoria, OH 44830-1304
Mailing address
2641 Brookside Dr
Fostoria, OH 44830-1304
Phone (567) 207-0596
Other providers in Fostoria, OH
- Jaime Christie
- CHS - Lake Erie, Inc
- CHS Lake Erie Inc
- Laura A Clouse
- Danielle Rene' Cook
- Monica Lisa Cross
- Abbigail Ann Dauterman
- Tonya Dauterman
- Laura A Davidson
- Edwin B. Davis
All providers in Fostoria, OH · Student in an Organized Health Care Education/Training Program in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 3, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.