Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Theodore R Dacosta, DO

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1114420155

Theodore R Dacosta, DO is a Student in an Organized Health Care Education/Training Program in West Orange, New Jersey. Works from 2 locations. Licensed in New Jersey.

Licensed in
NJ
In the registry since
2018
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

59 Main St Ste 1
West Orange, NJ 07052-5341
Phone: (973) 674-8866
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 26 McChesney Ct, West Orange, NJ 07052-1135 — (973) 699-3950

Specialties & licences

Gastroenterology Physician (primary) Taxonomy 207RG0100X · Licence 25MB12193600 (NJ)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X (NJ)

Record details

NPI number1114420155
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedMarch 15, 2018
Last updated in NPPESMay 30, 2024
Certification dateMay 30, 2024
Mailing address26 McChesney Ct, West Orange, NJ 07052-1135

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