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Contact Information

JESSICA R DACOSTA, APRN, AGNP
2 OLD NEW MILFORD RD STE 3D
BROOKFIELD, CT06804-2426
 Phone: 203-885-0910
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Medicine

207QG0300X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for JESSICA R DACOSTA · (Female)

NPI Number 1245971571
Status Active
Credentials APRN, AGNP
Entity Individual
Enumeration date 04/01/2022
Last updated 04/01/2022 - About 4 years ago
Sole proprietor 1 Yes
Identifiers
  • CT License # 10496
  • CT Other 10496 CT DEP OF HEALTH
Hospital affiliation(s) Not Available
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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