Da Costa, Gaston
Da Costa, Gaston is an individual health care provider with primary practice located at 740 S Limestone Ste B101 , Lexington KY 40536-8947. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neurology, Allopathic & Osteopathic Physicians / Clinical Neurophysiology. Allopathic & Osteopathic Physicians / Clinical Neurophysiology is his primary health care specialty. Da Costa, Gaston can be contacted via phone (859) 323-5661.Contact Information
Primary practice address
740 S Limestone Ste B101
Lexington KY 40536-8947
Phone: (859) 323-5661
Fax: (859) 323-6411
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 11010836A | Indiana |
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 01063806A | Indiana |
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | MD463417 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Clinical Neurophysiology | 2084N0600X | 59121 | Kentucky |
Profile Details
| NPI number | 1902011158 |
|---|---|
| LBN Legal business name | Da Costa, Gaston |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 11th, 2007 |
| Last updated | Apr 29th, 2024 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1902011158 | NPPES |
| Indiana | Other | P00787953 | RAILROAD MEDICARE PTAN |
| Indiana | MEDICAID | 200860440 | RAILROAD MEDICARE PTAN |
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