Gaston F Dacosta, MD | |
117 N. Mechanic Street, Carthage, NY 13619 | |
(315) 493-3100 | |
(315) 493-3113 |
Full Name | Gaston F Dacosta |
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Gender | Male |
Speciality | Obstetrics & Gynecology |
Location | 117 N. Mechanic Street, Carthage, New York |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1982788394 | NPI | - | NPPES |
01503075 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207VX0000X | Obstetrics & Gynecology - Obstetrics | 188409 (New York) | Secondary |
207V00000X | Obstetrics & Gynecology | 188409 (New York) | Primary |
Entity Name | Carthage Area Hospital Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1053497388 PECOS PAC ID: 9931010485 Enrollment ID: O20040209000856 |
Mailing Address | Practice Location Address |
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Gaston F Dacosta, MD 117 N. Mechanic Street, Carthage, NY 13619 Ph: (315) 493-3100 | Gaston F Dacosta, MD 117 N. Mechanic Street, Carthage, NY 13619 Ph: (315) 493-3100 |
Lisa Marie Sanches, MD Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 1001 West St, Carthage, NY 13619 Phone: 315-493-1000 | |
Richard G Hofmann, MD Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 117 N Mechanic Street, Carthage, NY 13619 Phone: 315-493-3100 Fax: 315-493-3113 | |
Kimberly Michele Ginyard, M.D. Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 117 N Mechanic St, Carthage, NY 13619 Phone: 315-493-3100 Fax: 315-493-3113 |