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General NPI Number Information
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NPI Number | 1447426432
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Entity Type | Individual
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Provider Name | VICTOR MANUEL DA COSTA M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/30/2008
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Last Update Date | 04/08/2024
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Provider Practice Location Address
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Address Line | 1430 HARRISBURG PIKE
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City | LANCASTER
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State | PA
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Zip | 17601-2615
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Country | US
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Telephone | 800-243-1455
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Fax | 717-606-1124
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Provider Business Mailing Address
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Address Line | 16 S EUTAW ST SUITE 500
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City | BALTIMORE
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State | MD
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Zip | 21201-1606
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Country | US
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Telephone | 410-328-3197
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YP0228X
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Taxonomy Name | Pediatric Otolaryngology Physician
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License Number | D75944
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207YP0228X
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Taxonomy Name | Pediatric Otolaryngology Physician
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License Number | MD456676
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License Number State | PA
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