Individual
DANIEL DACOSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
475 JACK MARTIN BLVD, BRICK, NJ 08724-7732
(732) 458-6699
Mailing address
201 8TH AVE APT 6B, BELMAR, NJ 07719-2259
(914) 438-5994
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR00803200
NJ
Other
Enumeration date
03/25/2018
Last updated
03/25/2018
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