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General NPI Number Information
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NPI Number | 1013902931
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Entity Type | Individual
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Provider Name | PETER ANGELO COGGIOLA MSN, NP
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Gender | Male
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Dates
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Enumeration Date | 09/16/2005
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Last Update Date | 12/08/2022
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Provider Practice Location Address
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Address Line | 39 DUNCAN ST
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City | WARSAW
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State | NY
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Zip | 14569-1017
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Country | US
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Telephone | 585-786-0190
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Fax | 585-786-0196
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Provider Business Mailing Address
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Address Line | 4470 JORDAN ROAD
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City | SILVER SPRINGS
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State | NY
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Zip | 14550
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Country | US
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Telephone | 614-484-8101
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Fax | 505-468-9629
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | F3304121
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | F402728
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License Number State | NY
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