Provider Demographics
NPI:1982392361
Name:DA COSTA NOBREGA, JOSE RENATO (MD)
Entity Type:Individual
Prefix:
First Name:JOSE RENATO
Middle Name:
Last Name:DA COSTA NOBREGA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE BROOKDALE PLAZA, THE BROOKDALE UNIVERSITY HOSPITAL
Mailing Address - Street 2:DEPARTMENT OF SURGICAL SERVICES, ROOM 222
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11212
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:ONE BROOKDALE PLAZA, THE BROOKDALE UNIVERSITY HOSPITAL
Practice Address - Street 2:DEPARTMENT OF SURGICAL SERVICES, ROOM 222
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212
Practice Address - Country:US
Practice Address - Phone:718-240-6386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program