Healthcare Provider Details

I. General information

NPI: 1023321478
Provider Name (Legal Business Name): GENNY CUOCCI LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2010
Last Update Date: 07/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 8TH AVE 3RD FLOOR
NEW YORK NY
10018-6504
US

IV. Provider business mailing address

211 BELLE CT
NORWOOD NJ
07648-1612
US

V. Phone/Fax

Practice location:
  • Phone: 212-904-1500
  • Fax:
Mailing address:
  • Phone: 201-694-0278
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number081438
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: