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NPI Code Detail

MEDICARE: RICHARD N COSTA PSY D

MEDICARE: RICHARD N COSTA PSY D
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
1103T00000XPsychologist946LA

General Provider Information

NPI Number : 1275544793
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD N COSTA PSY D
Provider Business Mailing Address
First Line : 1340 POYDRAS ST
Second Line : SUITE 1640
City : NEW ORLEANS
State : LA
Zip : 70112-1221
Country : US
Telephone Number : 504-412-1835
Fax Number :
Provider Business Practice Location Address
First Line : 3450 CHESTNUT ST
Second Line : 3RD FLOOR
City : NEW ORLEANS
State : LA
Zip : 70115-2443
Country : US
Telephone Number : 504-412-1580
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2006
Last Update Date : 10/23/2008

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Directions to “ RICHARD N COSTA PSY D” Practice Location

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