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General NPI Number Information
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NPI Number | 1629360599
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Entity Type | Individual
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Provider Name | SABRINA MONIQUE DACOSTA M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/10/2011
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Last Update Date | 10/18/2023
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Provider Practice Location Address
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Address Line | 99 BEAUVOIR AVE
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City | SUMMIT
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State | NJ
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Zip | 07901-3533
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Country | US
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Telephone | 908-522-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 20 YORK ST
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City | NEW HAVEN
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State | CT
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Zip | 06510-3220
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Country | US
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Telephone | 203-737-1549
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Fax | 203-785-6664
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 55359
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 036139555
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 25MA10670100
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License Number State | NJ
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