Individual
LARISSA M COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
236 MILFORD ST, UPTON, MA 01568-1309
(508) 473-1015
(508) 634-0261
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA6244
MA
363AM0700X
Medical Physician Assistant
PA6244
MA
Other
Enumeration date
08/25/2017
Last updated
07/24/2026
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