Christopher Dacosta, MD
Student in an Organized Health Care Education/Training Program in Newark, NJ. Individual provider (NPI-1).
NPI number1124862099
StatusActive
Last updated in NPPESJun 24, 2024
Details
- NPI
- 1124862099
- Entity type
- Individual (NPI-1)
- Name
- Christopher Dacosta
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 24, 2024
- Certification date
- Jun 24, 2024
- Last updated
- Jun 24, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
111 Central AveNewark, NJ 07102-1909
Phone 973-877-5000
Mailing address
111 Central AveNewark, NJ 07102-1909
Phone 973-945-9846
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