Individual
MR. JOHN H COSTA JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
200 TER HEUN DR, FALMOUTH, MA 02540-2525
(774) 392-7934
Mailing address
200 TER HEUN DR, FALMOUTH, MA 02540-2525
(774) 392-7934
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN211082
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN211082
MASSACHUSETTS BOARD OF NURSING
MA
Enumeration date
11/16/2022
Last updated
11/16/2022
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