Provider Demographics
NPI:1497562177
Name:COSTA ORTHOPEDICS, LLC
Entity type:Organization
Organization Name:COSTA ORTHOPEDICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:COSTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-440-7322
Mailing Address - Street 1:135 RT 35
Mailing Address - Street 2:SUITE 7
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724
Mailing Address - Country:US
Mailing Address - Phone:732-440-7322
Mailing Address - Fax:732-217-2483
Practice Address - Street 1:135 RT 35
Practice Address - Street 2:SUITE 7
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724
Practice Address - Country:US
Practice Address - Phone:732-440-7322
Practice Address - Fax:732-217-2483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty