Doctor Name: | DR. SUSAN PAKRAVAN COCOZIELLO |
NPI Number: | 1073687356 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | |
Business Practice Address: | 1 Broadway Suite 105 Elmwood Park, NJ - 074071842 |
Business Phone Number: | 2017736777 |
Business Fax Number: | 2013006880 |
Mailing Address: | 1 Broadway Suite, Suite 303 ELMWOOD PARK |
State: | NJ |
Postal Code: | 07407 |
Phone Number: | 2017947717 |
Fax Number: | 2017947717 |
NPI Enumeration Date: | 11/20/2006 |
NPI Last Update Date: | 11/04/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |