Individual
GASTON F DACOSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
117 N. MECHANIC STREET, CARTHAGE, NY 13619
(315) 493-3100
(315) 493-3113
Mailing address
117 N. MECHANIC STREET, CARTHAGE, NY 13619
(315) 493-3100
(315) 493-3113
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
188409
NY
207VX0000X
Obstetrics Physician
188409
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01503075
—
NY
Enumeration date
10/24/2006
Last updated
05/05/2021
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