Provider Demographics
NPI:1285892604
Name:REESE, ERIN MARIE COSTELLO (DO)
Entity type:Individual
Prefix:DR
First Name:ERIN
Middle Name:MARIE COSTELLO
Last Name:REESE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:ERIN
Other - Middle Name:M
Other - Last Name:COSTELLO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:201 STATE ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16550-0002
Mailing Address - Country:US
Mailing Address - Phone:814-877-6139
Mailing Address - Fax:814-877-6093
Practice Address - Street 1:201 STATE ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16550-0002
Practice Address - Country:US
Practice Address - Phone:814-877-6139
Practice Address - Fax:814-877-6093
Is Sole Proprietor?:No
Enumeration Date:2008-06-02
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS014384207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine