Theodore R Dacosta, DO is a student in an organized health care education training program in West Orange, NJ. The provider is 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. Theodore R Dacosta, DO NPI is 1114420155. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
The provider's business location address is:
26 MCCHESNEY CT
WEST ORANGE, NJ
ZIP 07052-135
Phone: (973) 699-3950
The enumeration date for this NPI number is 3/15/2018 and was last updated on 3/15/2018.