National Provider Identifier Database

THEODORE A DACOSTA JR, MD – NPI #1558395673
Gastroenterology

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.


Contact Information

THEODORE A DACOSTA JR, MD
85 S JEFFERSON STREET
CITY OF ORANGE, NJ07050
Phone: 973-674-8866
Fax: 973-672-9299
Website:
Specialty Taxonomy Code
* Gastroenterology 207RG0100X
Internal Medicine 207R00000X

* Indicates primary specialty

NPI Profile & details for THEODORE A DACOSTA JR

NPI Number 1558395673
Credentials MD
Entity Individual
Enumeration date 07/11/2006
Last updated 09/11/2025 - About 9 months ago
Sole proprietor1 No
Identifiers
  • NJ License #: 25MA05600200
  • NJ Medicaid: 6881106
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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