Provider Demographics
NPI:1730289927
Name:COCCO, MICHAEL ALAN (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ALAN
Last Name:COCCO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BRADLEY RD
Mailing Address - Street 2:STE 203
Mailing Address - City:WOODBRIDGE
Mailing Address - State:CT
Mailing Address - Zip Code:06525-2235
Mailing Address - Country:US
Mailing Address - Phone:203-397-2211
Mailing Address - Fax:203-389-4055
Practice Address - Street 1:194 AMITY RD
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:CT
Practice Address - Zip Code:06525-2239
Practice Address - Country:US
Practice Address - Phone:203-397-2211
Practice Address - Fax:203-389-4055
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2022-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000552111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT793570OtherCONNECTICARE
CTCT00552OtherLANDMARK HEALTHCARE
CTP1118352OtherOXFORD HEALTHPLAN
CT050000552CT02OtherANTHEM BC/BS
CTP1118352OtherOXFORD HEALTHPLAN