Basic Information
| Provider Information | |||||||||
| NPI: | 1518346063 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COSTA | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | PEREIRA | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | ST. CHRISTOPHER'S HOSPITAL FOR CHILDREN | ||||||||
| Address2: | 160 E. ERIE AVE | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2154275000 | ||||||||
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| Practice Location | |||||||||
| Address1: | ADVOCARE DELGIORNO PEDIATRIC & ADULT MEDICINE | ||||||||
| Address2: | 535 S. BLACK HORSE PIKE | ||||||||
| City: | BLACKWOOD | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080122868 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8562281061 | ||||||||
| FaxNumber: | 8562281907 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/29/2015 | ||||||||
| LastUpdateDate: | 03/21/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | MT208886 | PA | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | 25MA10289200 | NJ | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.