Provider Demographics
NPI:1467919597
Name:COZZOLINO, DAWN M
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:M
Last Name:COZZOLINO
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:DAWN
Other - Middle Name:M
Other - Last Name:COZZOLINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:38 MINKEL RD
Mailing Address - Street 2:
Mailing Address - City:OSSINING
Mailing Address - State:NY
Mailing Address - Zip Code:10562-2131
Mailing Address - Country:US
Mailing Address - Phone:914-760-1396
Mailing Address - Fax:
Practice Address - Street 1:225 BROADHOLLOW RD STE 402
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-4899
Practice Address - Country:US
Practice Address - Phone:631-385-7780
Practice Address - Fax:631-385-7795
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-25
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician