Provider Demographics
NPI:1780685487
Name:COSTA, DONALD J (DC)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:J
Last Name:COSTA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 THOMPSON RUN RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-3759
Mailing Address - Country:US
Mailing Address - Phone:412-487-5155
Mailing Address - Fax:412-487-5155
Practice Address - Street 1:411 THOMPSON RUN RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-3759
Practice Address - Country:US
Practice Address - Phone:412-487-5155
Practice Address - Fax:412-487-5155
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC001498L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102480OtherUPMC
PACO167876OtherHIGH MARK
PACO167876Medicare ID - Type Unspecified
PA102480OtherUPMC