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Individual

SANDRA C DACOSTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPNP

Contact information

Practice address
225 FIELD ST, NEW BEDFORD, MA 02740-2134
(508) 910-3371
(508) 910-3363
Mailing address
225 FIELD ST, NEW BEDFORD, MA 02740-2134
(508) 910-3371
(508) 910-3363

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
252152
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0703567
MA
Enumeration date
09/20/2005
Last updated
03/07/2012
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