Kevin Costello, DPT
Physical Therapist in Lynbrook, NY. Individual provider (NPI-1).
NPI number1104169929
StatusActive
Last updated in NPPESNov 28, 2022
Details
- NPI
- 1104169929
- Entity type
- Individual (NPI-1)
- Name
- Kevin Costello
- Credential
- DPT
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 29, 2013
- Certification date
- Nov 28, 2022
- Last updated
- Nov 28, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICAL THERAPIST IN PRIVATE PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 049876 | NY | Yes |
| 225100000X | Physical Therapist | Pt02564 | RI |
Practice location
225 Merrick RdLynbrook, NY 11563-2621
Phone 516-599-8734 · Fax 516-599-8730
Mailing address
225 Merrick RdLynbrook, NY 11563-2621
Phone 516-599-8734 · Fax 516-599-8730
Other practice locations
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 52 Physical Therapist providers in Lynbrook · All 891 providers in Lynbrook
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