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General NPI Number Information
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NPI Number | 1033144084
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Entity Type | Individual
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Provider Name | DOMINICA CATHERINE COSTELLO D.O.
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Gender | Female
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 11/04/2022
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Provider Practice Location Address
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Address Line | 110 HAVERHILL RD STE 505
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City | AMESBURY
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State | MA
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Zip | 01913-2150
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Country | US
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Telephone | 978-473-3221
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Fax | 833-629-0822
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Provider Business Mailing Address
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Address Line | 110 HAVERHILL RD STE 505
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City | AMESBURY
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State | MA
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Zip | 01913-2150
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Country | US
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Telephone | 978-473-3221
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Fax | 833-629-0822
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 13107
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 220100
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License Number State | MA
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