Healthcare Provider Details

I. General information

NPI: 1841121027
Provider Name (Legal Business Name): LAUREN MOCCIA DNP CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 RIVER RD APT 12
COS COB CT
06807-2505
US

IV. Provider business mailing address

115 RIVER RD APT 12
COS COB CT
06807-2505
US

V. Phone/Fax

Practice location:
  • Phone: 845-642-7360
  • Fax:
Mailing address:
  • Phone: 845-642-7360
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number158450
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: