MEDICARE: DR. RACHAEL M COCCHIA DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	22DI02719400	NJ

General Provider Information

NPI Number	:	1144719279
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RACHAEL M COCCHIA DMD

Provider Business Mailing Address
First Line	:	160 SUMMIT AVE STE 101
Second Line	:
City	:	MONTVALE
State	:	NJ
Zip	:	07645-1763
Country	:	US
Telephone Number	:	201-775-4565
Fax Number	:	551-788-0724

Provider Business Practice Location Address
First Line	:	160 SUMMIT AVE STE 101
Second Line	:
City	:	MONTVALE
State	:	NJ
Zip	:	07645-1763
Country	:	US
Telephone Number	:	201-775-4565
Fax Number	:	551-788-0724

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2018
Last Update Date	:	01/02/2026

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