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NPI Code Detail

MEDICARE: DR. JOSEPH P. COSTABILE M.D.

MEDICARE: DR. JOSEPH P. COSTABILE M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery Physician25MA05499800NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1376592675
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSEPH P. COSTABILE M.D.
Provider Business Mailing Address
First Line : 301 LIPPINCOTT DR STE 410
Second Line :
City : MARLTON
State : NJ
Zip : 08053-4197
Country : US
Telephone Number : 856-355-0340
Fax Number : 856-355-0330
Provider Business Practice Location Address
First Line : 1935 ROUTE 70 E
Second Line :
City : CHERRY HILL
State : NJ
Zip : 08003-2117
Country : US
Telephone Number : 856-428-7700
Fax Number : 856-424-9120
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2006
Last Update Date : 01/07/2026

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