Provider Demographics
NPI:1558733303
Name:COZZETTI, DENISE KAREN
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:KAREN
Last Name:COZZETTI
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 1:1362 MANOR LN
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-3734
Mailing Address - Country:US
Mailing Address - Phone:631-665-2123
Mailing Address - Fax:
Practice Address - Street 1:1362 MANOR LN
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-3734
Practice Address - Country:US
Practice Address - Phone:631-665-2123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-20
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY343518050214E163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse