Individual
ALLISON COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
14995 SHADY GROVE RD STE 150, ROCKVILLE, MD 20850-8732
(301) 358-5919
Mailing address
14995 SHADY GROVE RD STE 150, ROCKVILLE, MD 20850-8732
(301) 358-5919
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110-007985
VA
363A00000X
Physician Assistant
Primary
C08063
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/01/2020
Last updated
09/13/2021
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