Provider Demographics
NPI:1518292754
Name:LOCOCO, NICOLETTA
Entity Type:Individual
Prefix:
First Name:NICOLETTA
Middle Name:
Last Name:LOCOCO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 JASMINE AVE
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-2726
Mailing Address - Country:US
Mailing Address - Phone:716-603-4560
Mailing Address - Fax:
Practice Address - Street 1:2005 SHERIDAN DR
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14223-1222
Practice Address - Country:US
Practice Address - Phone:716-541-9102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-06
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services