MEDICARE: ACOSTA, PC

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
1	207R00000X	Internal Medicine Physician		PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CB4860	OTHER		RAILROAD
2	789831	OTHER		BS

General Provider Information

NPI Number	:	1982602355
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACOSTA, PC

Provider Business Mailing Address
First Line	:	3128 WILMINGTON RD
Second Line	:
City	:	NEW CASTLE
State	:	PA
Zip	:	16105-1132
Country	:	US
Telephone Number	:	724-658-3020
Fax Number	:	724-658-6094

Provider Business Practice Location Address
First Line	:	3128 WILMINGTON RD
Second Line	:
City	:	NEW CASTLE
State	:	PA
Zip	:	16105-1132
Country	:	US
Telephone Number	:	724-658-3020
Fax Number	:	724-658-6094

Authorized Official
Title or Position	:	OWNER/DIRECTOR
Name	:	ELBERT R ACOSTA II
Credential	:	MD
Telephone Number	:	724-658-3020

Provider Enumeration Date	:	07/11/2005
Last Update Date	:	07/21/2022

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