Provider Demographics
NPI:1851349724
Name:COSTA, SARA (PT)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:
Last Name:COSTA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:SCHWARTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:227 CENTERVILLE RD FL 2
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-4394
Mailing Address - Country:US
Mailing Address - Phone:401-732-8200
Mailing Address - Fax:401-732-8230
Practice Address - Street 1:227 CENTERVILLE RD FL 2
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-4394
Practice Address - Country:US
Practice Address - Phone:401-732-8200
Practice Address - Fax:401-732-8230
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT01648225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI050513332OtherGREATWEST
RI412807OtherBLUE CHIP BLUE SHIELD
RI7318801OtherAETNA
RI050513332OtherUNITEDHEALTHCARE
RI30948OtherBLUE CROSS BLUE SHIELD
RIAA1566OtherPILGRIM
RIP00318839OtherMEDICARE RAILROAD
RIAA1566OtherPILGRIM
RIQ60383Medicare UPIN