Individual
ANTONIO MANUEL COSTA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1040 CHESTNUT ST, EMMAUS, PA 18049-1952
(610) 966-5549
Mailing address
PO BOX 783311, PHILADELPHIA, PA 19178-3311
(484) 884-4500
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS018144
PA
Other
Enumeration date
04/16/2013
Last updated
03/07/2019
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