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General NPI Number Information
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NPI Number | 1710786421
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Entity Type | Individual
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Provider Name | ARIANNA B CUOCCO PA-C
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Gender | Female
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Dates
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Enumeration Date | 03/13/2025
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 4 TECHNOLOGY DR
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City | EAST SETAUKET
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State | NY
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Zip | 11733-4080
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Country | US
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Telephone | 631-246-8289
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Fax |
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Provider Business Mailing Address
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Address Line | 143 DAVIS AVE
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City | PORT JEFFERSON STATION
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State | NY
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Zip | 11776-2025
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Country | US
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Telephone | 631-626-7116
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Fax |
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 033514
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License Number State | NY
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