Gina Marie Costello, MD
Individual provider Active NPI Pediatric Adolescent Medicine Physician · Swansea, MA
NPI 1770558488 · NPPES record last updated Jan 23, 2012
Key facts
- NPI
- 1770558488
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Adolescent Medicine Physician 2080A0000X
- License
- 226978 (MA)
- Practice address
- 2200 Gar Hwy
Swansea, MA 02777-3935 - Phone
- (508) 379-9605
- Fax
- (508) 379-9813
- NPI assigned
- Feb 17, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 226978 | MA | MD | Pediatric Adolescent Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Swansea Pediatric Associates LLC | Past | Accepting new patients |
Interoperability endpoints
- gcostello8183@direct.chppoc.masshiway.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Adolescent Medicine Physician | 2080A0000X | 226978 | MA | Yes |
Addresses
Primary practice location
2200 Gar Hwy
Swansea, MA 02777-3935
Mailing address
2200 Gar Hwy
Swansea, MA 02777-3935
Phone (508) 379-9605
Other providers in Swansea, MA
- Contemporary Chiropractic Neurology
- Anna Bryn Conway
- Kristin Corey
- Brian Costa
- John M F Costa
- Heidi Marie Cote
- Susan Cotta
- Linda Krein Cullen
- Cultured Care, Inc.
- Cultured Nursing
All providers in Swansea, MA · Pediatric Adolescent Medicine Physician in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 23, 2012. 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.