Provider Demographics
NPI:1477595734
Name:COCOZZA, DONALD JOSEPH (PT)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:JOSEPH
Last Name:COCOZZA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N 1ST ST STE 103
Mailing Address - Street 2:STEP AHEAD PHYSICAL THERAPY
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91502-1845
Mailing Address - Country:US
Mailing Address - Phone:818-846-7100
Mailing Address - Fax:818-846-7101
Practice Address - Street 1:100 N 1ST ST STE 103
Practice Address - Street 2:STEP AHEAD PHYSICAL THERAPY
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91502-1845
Practice Address - Country:US
Practice Address - Phone:818-846-7100
Practice Address - Fax:818-846-7101
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2008-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT29089225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT29089CMedicare ID - Type Unspecified