Healthcare Provider Details

I. General information

NPI: 1700217148
Provider Name (Legal Business Name): JOSEPH CUOCCIO D.P.T
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2013
Last Update Date: 12/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 MERRICK AVE
EAST MEADOW NY
11554-4748
US

IV. Provider business mailing address

50 WHALERS CV
BABYLON NY
11702-2923
US

V. Phone/Fax

Practice location:
  • Phone: 516-393-8900
  • Fax: 516-393-8869
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number033410-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: