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General NPI Number Information
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NPI Number | 1295929867
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Entity Type | Organization
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Legal Business Name | DR RAMIN B COCOZIELLO MD PC
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Dates
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Enumeration Date | 08/28/2007
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 12-15 BROADWAY SUITE E
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City | FAIR LAWN
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State | NJ
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Zip | 07410-2031
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Country | US
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Telephone | 201-794-0910
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Fax | 201-794-2164
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Provider Business Mailing Address
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Address Line | 12-15 BROADWAY SUITE E
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City | FAIR LAWN
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State | NJ
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Zip | 07410-2031
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Country | US
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Telephone | 201-794-0910
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Fax | 201-794-2164
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Authorized Official
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Title or Position | OWNER
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Name | DR. RAMIN BARRY COCOZIELLO
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Credential | MD
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Telephone | 201-794-0910
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 25MA06185100
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License Number State | NJ
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