Provider Demographics
NPI:1043491830
Name:COSTA, JOSE C (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:C
Last Name:COSTA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:76 INDEPENDENCE DR
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-3227
Mailing Address - Country:US
Mailing Address - Phone:732-609-3041
Mailing Address - Fax:732-254-4610
Practice Address - Street 1:465 CRANBURY RD
Practice Address - Street 2:SUITE 102
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-7600
Practice Address - Country:US
Practice Address - Phone:732-390-1995
Practice Address - Fax:732-254-4610
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-20
Last Update Date:2015-09-23
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA08477200207RG0100X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine