MEDICARE: MRS. BRIDGET LUCILLE COCCARO MSN, FNP

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	163WC0200X	Critical Care Medicine Registered Nurse	527175	NY
2	363LF0000X	Family Nurse Practitioner	338636	NY

General Provider Information

NPI Number	:	1841619558
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BRIDGET LUCILLE COCCARO MSN, FNP

Provider Business Mailing Address
First Line	:	60 GOLDENS BRIDGE RD
Second Line	:
City	:	KATONAH
State	:	NY
Zip	:	10536-3447
Country	:	US
Telephone Number	:	914-232-1919
Fax Number	:

Provider Business Practice Location Address
First Line	:	1838 COMMERCE ST
Second Line	:
City	:	YORKTOWN HEIGHTS
State	:	NY
Zip	:	10598-4400
Country	:	US
Telephone Number	:	914-962-3500
Fax Number	:	914-245-7875

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

Provider Enumeration Date	:	04/09/2014
Last Update Date	:	11/12/2014

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