Provider Demographics
NPI:1619305919
Name:COICOU, CAROLINE (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:
Last Name:COICOU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CAROLINE
Other - Middle Name:
Other - Last Name:COICOU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:450 CLARKSON AVE
Mailing Address - Street 2:BOX 57
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-2012
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:450 CLARKSON AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2012
Practice Address - Country:US
Practice Address - Phone:718-270-1801
Practice Address - Fax:718-270-2653
Is Sole Proprietor?:No
Enumeration Date:2013-10-23
Last Update Date:2017-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY285176207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine