Provider Demographics
NPI:1902411010
Name:COCO, ANGELINA MARIA (DNP)
Entity Type:Individual
Prefix:
First Name:ANGELINA
Middle Name:MARIA
Last Name:COCO
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 CHANDLER ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01609-3088
Mailing Address - Country:US
Mailing Address - Phone:508-860-7888
Mailing Address - Fax:508-796-7053
Practice Address - Street 1:199 CHANDLER ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01609-3088
Practice Address - Country:US
Practice Address - Phone:508-860-7888
Practice Address - Fax:508-796-7053
Is Sole Proprietor?:No
Enumeration Date:2020-09-15
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2319677363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology