MATTHEW JACOB DACOSTA

PROVIDENCE, RI
NPI1093201667
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: RI  PA01269)
Enumeration Date2018-07-07
Last Update Date2020-10-23
Business Address
MATTHEW JACOB DACOSTA PA-C
180 CORLISS ST STE B
PROVIDENCE, RI 02904-2602
Phone number: 401-793-8400
Mailing Address
MATTHEW JACOB DACOSTA PA-C
111 FRANKLIN ST APT 2
BRISTOL, RI 02809-2327
Phone number: 508-264-1979
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