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

MS. Kelly Jo Costello

Individual provider Specialist · NPI 1700653151

MS. Kelly Jo Costello is a Specialist in Port Jefferson, New York. Practices as a sole proprietor. Registered with an NPI since 2023.

In the registry since
2023
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Practice location Address checks out

299 Hallock Ave
Port Jefferson, NY 11776
Phone: (540) 532-8002
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X

Record details

NPI number1700653151
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedDecember 6, 2023
Last updated in NPPESDecember 6, 2023
Certification dateNovember 30, 2023

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