Provider Demographics
NPI:1295700342
Name:COSTA, JOSHUA PAUL (PT DPT)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:PAUL
Last Name:COSTA
Suffix:
Gender:M
Credentials:PT DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2730 UNIVERSITY BLVD W STE 310
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:MD
Mailing Address - Zip Code:20902-1990
Mailing Address - Country:US
Mailing Address - Phone:301-942-7600
Mailing Address - Fax:301-942-3521
Practice Address - Street 1:14995 SHADY GROVE RD STE 260
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-8727
Practice Address - Country:US
Practice Address - Phone:301-929-4125
Practice Address - Fax:301-251-0495
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027487225100000X
MD21811225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD175548ZADUMedicare PIN
NY7887773OtherAETNA PPO