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NPI Code Detail

MEDICARE: KATRINA ACOSTA MD

MEDICARE: KATRINA ACOSTA MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician13891NH
22085R0202XDiagnostic Radiology Physician042-0011537VT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1437136306
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATRINA ACOSTA MD
Provider Business Mailing Address
First Line : 243 ELM ST
Second Line : RADIOLOGY DEPARTMENT
City : CLAREMONT
State : NH
Zip : 03743-4921
Country : US
Telephone Number : 603-543-3409
Fax Number : 503-543-8981
Provider Business Practice Location Address
First Line : 243 ELM ST
Second Line : RADIOLOGY DEPARTMENT
City : CLAREMONT
State : NH
Zip : 03743-4921
Country : US
Telephone Number : 603-543-3409
Fax Number : 503-543-8981
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/30/2005
Last Update Date : 02/25/2010

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Directions to “ KATRINA ACOSTA MD” Practice Location

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