Individual
MATTHEW JACOB DACOSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
827 AMERICAN LEGION HWY, WESTPORT, MA 02790-4128
(508) 636-5101
(508) 636-3651
Mailing address
111 FRANKLIN ST APT 2, BRISTOL, RI 02809-2327
(508) 264-1979
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA01269
RI
363A00000X
Physician Assistant
Primary
PA7684
MA
Other
Enumeration date
07/07/2018
Last updated
11/07/2025
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