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Alice Mary Costello, FNP

Nurse Practitioner, Family in Rochester, NY. Individual provider (NPI-1).

NPI number1982203360
StatusActive
Last updated in NPPESJul 3, 2023

Details

NPI
1982203360
Entity type
Individual (NPI-1)
Name
Alice Mary Costello
Credential
FNP
Sex
Female
Sole proprietor
No
Enumeration date
Oct 18, 2020
Certification date
Jan 4, 2021
Last updated
Jul 3, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, Family345596NYYes
207Q00000X Family MedicineF345596NY

Practice location

10 S Pointe Lndg Ste 250
Rochester, NY 14606-3483

Phone 585-426-4084 · Fax 585-426-4631

Mailing address

10 S Pointe Lndg Ste 250
Rochester, NY 14606-3483

Phone 585-426-4084 · Fax 585-426-4631

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