Provider Demographics
NPI:1033567995
Name:COCKREN, DANIEL (LPN)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:COCKREN
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 ACADEMY RD
Mailing Address - Street 2:PARSONS CHILD FAMILY CENTER
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208
Mailing Address - Country:US
Mailing Address - Phone:518-426-7254
Mailing Address - Fax:518-292-5440
Practice Address - Street 1:60 ACADEMY RD
Practice Address - Street 2:PARSONS CHILD AND FAMILY CENTER
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208
Practice Address - Country:US
Practice Address - Phone:518-426-7254
Practice Address - Fax:518-292-5440
Is Sole Proprietor?:No
Enumeration Date:2016-06-01
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY307898164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse