MEDICARE: MILENA DA COSTA PT

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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1972076867
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MILENA DA COSTA PT

Provider Business Mailing Address
First Line	:	11676 PERRY HWY STE 2309
Second Line	:
City	:	WEXFORD
State	:	PA
Zip	:	15090-7200
Country	:	US
Telephone Number	:	412-345-1127
Fax Number	:

Provider Business Practice Location Address
First Line	:	11676 PERRY HWY STE 2309
Second Line	:
City	:	WEXFORD
State	:	PA
Zip	:	15090-7200
Country	:	US
Telephone Number	:	678-880-9597
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2019
Last Update Date	:	03/03/2025

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Directions to “ MILENA DA COSTA PT” Practice Location

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