Individual provider · Type 1 NPI

Melissa Dacosta

Medical Physician Assistant · Wethersfield, CT

NPI number 1487100079 Active

Practice location

1290 Silas Deane Hwy, 2nd Floor
Wethersfield, CT 06109-4337

Call (860) 972-5098 Map

Mailing address

42 Town St
Norwich, CT 06360-2316

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000XNone listed
Medical Physician Assistant Primary 363AM0700X3670 (CT)

Medical Physician Assistant: Definition to come...

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About NPI 1487100079

Melissa Dacosta's National Provider Identifier is 1487100079, issued on Sep 1, 2016. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Wethersfield, CT. The record was last updated on Nov 17, 2016.