Susan Cocoziello MD LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

MB25981 Issued in NJ

Legal business name

SUSAN COCOZIELLO MD LLC

Practice address

1 Broadway
Suite 303
Elmwood Park, NJ 07407-1845

Phone

(201) 794-7717

Fax

(201) 794-0335

NPI assigned

Mar 20, 2013

Last updated

Aug 9, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Susan Pakravan Cocoziello, M.DNPI 1073687356

Title

Owner

Phone

(201) 794-7717

Specialties & licenses 1

Addresses

Other names 1

• susan cocoziello md llc Former legal business name

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Susan Pakravan Cocoziello, M.D.

  • Specialist
  • Elmwood Park, NJ
  • NPI 1073687356
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1363737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376006400000",
    "number": "1598007395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BROADWAY",
            "address_2": "SUITE 303",
            "city": "ELMWOOD PARK",
            "state": "NJ",
            "postal_code": "074071842",
            "telephone_number": "201-794-7717",
            "fax_number": "201-794-0335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BROADWAY",
            "address_2": "SUITE 303",
            "city": "ELMWOOD PARK",
            "state": "NJ",
            "postal_code": "074071845",
            "telephone_number": "201-794-7717",
            "fax_number": "201-794-0335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN COCOZIELLO MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-20",
        "last_updated": "2013-08-09",
        "status": "A",
        "authorized_official_last_name": "COCOZIELLO",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "PAKRAVAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-794-7717",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "MB25981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "susan cocoziello md llc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Specialist in Elmwood Park, NJ
• Providers in Elmwood Park, NJ by specialty
• Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.