Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | C10011372 | DE |
NPI | 1003058561 |
---|---|
Provider Name | Joanna Costa |
First Address | Rockland, DE 19732-0191 |
Second Address | Wilmington, DE 19803-3607 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2009 |
Last Update Date | 17/09/2015 |