Provider Demographics
NPI:1922459981
Name:COZZA, DANIELLE ROSE (OD)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:ROSE
Last Name:COZZA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1683 VILLAGE GREEN DR
Mailing Address - Street 2:
Mailing Address - City:CLAIRTON
Mailing Address - State:PA
Mailing Address - Zip Code:15025-3050
Mailing Address - Country:US
Mailing Address - Phone:570-772-6770
Mailing Address - Fax:
Practice Address - Street 1:701 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:NORTH CHARLEROI
Practice Address - State:PA
Practice Address - Zip Code:15022-2422
Practice Address - Country:US
Practice Address - Phone:724-483-8055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-30
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG003201152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist