Dacosta Medical Group LLC
NPI #1346461282 in Orange, New Jersey
Provider Information
- NPI Number
- 1346461282
- Entity Type
- Organization
- Organization Name
- Dacosta Medical Group LLC
- Primary Specialty
- Internal Medicine - Gastroenterology
- Enumeration Date
- May 1, 2007
- Last Updated
- Apr 23, 2010
Practice Location
- Address
- 85 S JEFFERSON STREET
- City
- Orange
- State
- New Jersey
- ZIP Code
- 07050
- Phone
- (973) 674-8866
Authorized Official
- Name
- DR. THEODORE DACOSTA, MD
- Title
- PHYSICIAN
- Phone
- (973) 674-8866
Specialties & Taxonomy Codes
| Specialty |
|---|
| Internal Medicine - Gastroenterology — Gastroenterology |
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