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General NPI Number Information
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NPI Number | 1740241546
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Entity Type | Individual
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Provider Name | SANDRA R COSTA DO
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Gender | Female
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Dates
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Enumeration Date | 03/31/2006
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 701 N DUPONT BLVD
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City | MILFORD
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State | DE
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Zip | 19963-1003
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Country | US
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Telephone | 302-725-3420
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Fax | 302-725-3430
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Provider Business Mailing Address
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Address Line | 3 WALNUT ST SUITE 205
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City | LEMOYNE
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State | PA
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Zip | 17043
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Country | US
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Telephone | 717-909-0520
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Fax | 717-909-4676
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | OS012622
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS012622
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | C2-0011328
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License Number State | DE
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