Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ann R Costello

Organization Non-Pharmacy Dispensing Site · NPI 1144635087

Ann R Costello is a Non-Pharmacy Dispensing Site in Ithaca, New York. Licensed in New York. Registered with an NPI since 2014.

Licensed in
NY
In the registry since
2014

Practice location Address checks out

217 N Aurora St Ste 2
Ithaca, NY 14850-4345
Phone: (607) 273-2811
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Non-Pharmacy Dispensing Site (primary) Taxonomy 332900000X · Licence 149866 (NY)

Record details

NPI number1144635087
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationMedvantx, Inc
Authorized official Scott Peterson — Cfo · (858) 625-2990
Other names Costello And Costello Mds
NPI enumeratedJune 30, 2014
Last updated in NPPESJanuary 13, 2017
Mailing address9276 Scranton Rd, Suite 100, San Diego, CA 92121-7701

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