Theodore R Dacosta, DO
Internal Medicine, Gastroenterology in West Orange, New Jersey
1114420155- Practice location
- 59 Main St Ste 1, West Orange, NJ 07052-5341
- Phone
- 973-674-8866
- Fax
- —
- Last updated
- May 30, 2024
Theodore R Dacosta is an Internal Medicine, Gastroenterology based in West Orange, NJ. Theodore R Dacosta practices in West Orange, NJ and has the professional credentials of DO. The NPI Number for Theodore R Dacosta is 1114420155 and holds a License No. 25MB12193600 (NJ). The current practice location address for Theodore R Dacosta is 59 Main St Ste 1, West Orange, NJ 07052-5341 and can be reached out via phone at 973-674-8866.
Provider Profile Details
- NPI Number
- 1114420155
- Provider Name
- Theodore R Dacosta
- Credential
- DO
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 59 Main St Ste 1, West Orange, NJ 07052-5341
- Phone Number
- 973-674-8866
- Primary Taxonomy
- Internal Medicine, Gastroenterology · 207RG0100X
- Sole Proprietor
- No
- Provider Enumeration Date
- March 15, 2018
- Last Update Date
- May 30, 2024
- Certification Date
- May 30, 2024
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 59 Main St Ste 1
West Orange, NJ 07052-5341 - City
- West Orange
- State
- New Jersey
- Zip
- 07052-5341
- Phone Number
- 973-674-8866
Provider Business Mailing Address Details
- Address
- 26 Mcchesney CT
West Orange, NJ 07052-1135 - City
- West Orange
- State
- NJ
- Zip
- 07052-1135
- Phone Number
- 973-699-3950
License Information
- License State (1)
- NJ
- Taxonomy (1)
- Student in an Organized Health Care Education/Training Program · 390200000X
- License Number (2)
- 25MB12193600
- License State (2)
- NJ
- Taxonomy (2)
- Internal Medicine, Gastroenterology · 207RG0100X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Internal Medicine, Gastroenterology providers near West Orange, NJ
View all Internal Medicine, Gastroenterology providers in West Orange →- Advanced Gastroenterology, PAInternal Medicine, Gastroenterology · NPI 1164739447
- Affiliates In Gastroenterology PAInternal Medicine, Gastroenterology · NPI 1689728479
- Barnabas Health MultispecialtyInternal Medicine, Gastroenterology · NPI 1538597745
- Dr. Elias G Estifan, MDInternal Medicine, Gastroenterology · NPI 1871023192
- Dr. Jon D Green, MDInternal Medicine, Gastroenterology · NPI 1245283563
- GastrocureInternal Medicine, Gastroenterology · NPI 1912236530
Frequently Asked Questions
What is the NPI number of Theodore R Dacosta, DO?
The NPI number of Theodore R Dacosta, DO is 1114420155. It was assigned on March 15, 2018 and is currently active in the NPPES registry.
What is the specialty of Theodore R Dacosta, DO?
Theodore R Dacosta, DO is registered under the primary taxonomy Internal Medicine, Gastroenterology (code 207RG0100X), licensed in NJ under license number 25MB12193600.
Where does Theodore R Dacosta, DO practice?
The practice location is 59 Main St Ste 1, West Orange, NJ 07052-5341. The office can be reached at 973-674-8866 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1114420155 directly on the NPPES registry website.