Provider Demographics
NPI:1497910962
Name:COCOZZO, CHRISTINA (DDS)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:COCOZZO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 HEMPHILL PL
Mailing Address - Street 2:SUITE 151
Mailing Address - City:MALTA
Mailing Address - State:NY
Mailing Address - Zip Code:12020-4426
Mailing Address - Country:US
Mailing Address - Phone:518-899-5800
Mailing Address - Fax:
Practice Address - Street 1:4 HEMPHILL PL
Practice Address - Street 2:SUITE 151
Practice Address - City:MALTA
Practice Address - State:NY
Practice Address - Zip Code:12020-4426
Practice Address - Country:US
Practice Address - Phone:518-899-5800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-24
Last Update Date:2009-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046198122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist