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Theodore R Dacosta, DO
Gastroenterology Physician in West Orange, New Jersey
NPI 1114420155

Theodore R Dacosta is a Gastroenterology Physician based in West Orange, NJ and is specialized in Gastroenterology. 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. (New Jersey).

The current practice location address for Theodore R Dacosta is 59 Main St Ste 1, West Orange, NJ and can be reached out via phone at 973-674-8866.

Location: 59 Main St Ste 1, West Orange, NJ, 07052-1135
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
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, 07052-1135
Phone Number
973-674-8866
Fax Number
Provider Enumeration Date
03/15/2018
Last Update Date
06/15/2024
institution
Provider Business Practice Location Address Details
Address
59 Main St Ste 1
City
West Orange
State
New Jersey
Zip
07052-5341
Phone Number
973-674-8866
Fax Number
person
Provider Business Mailing Address Details
Address
59 Main St Ste 1
City
West Orange
State
New Jersey
Zip
07052-5341
Phone Number
973-674-8866
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Internal Medicine
Speciality
Gastroenterology
Taxonomy
207RG0100X
License No.
25MB12193600 (New Jersey)
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
(New Jersey)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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