Physician Compare National (NPI:1538178504)

HEALTHCARE PROVIDER: LAURA A COSTELLO MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1538178504
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2264618750
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20111017000011
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	COSTELLO
	Individual professional last name
Provider First Name	LAURA
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON
	Individual professional's medical school
Graduation Year	1992
	Individual professional's medical school graduation year
Primary Specialty	OBSTETRICS/GYNECOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	ROBERT H DROPKIN MD LAURA A COSTELLO MD OB-GYN LLP
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	4284810805
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	2
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	6 EXECUTIVE PARK DR
	Group Practice or individual's line 1 address
City	ALBANY
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	122033791
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5184897439
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	330057
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST PETER'S HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	330013
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	ALBANY MEDICAL CENTER HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	330180
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	SAMARITAN HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	330153
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	ELLIS HOSPITAL
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y