Provider Demographics
NPI:1255596185
Name:COX, NICOLE (PSYD)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:
Last Name:COX
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3380 RESERVOIR OVAL
Mailing Address - Street 2:CHILD ADVOCACY CENTER
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-3101
Mailing Address - Country:US
Mailing Address - Phone:718-696-4120
Mailing Address - Fax:718-231-0833
Practice Address - Street 1:3380 RESERVOIR OVAL
Practice Address - Street 2:CHILD ADVOCACY CENTER
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-3101
Practice Address - Country:US
Practice Address - Phone:718-696-4120
Practice Address - Fax:718-231-0833
Is Sole Proprietor?:No
Enumeration Date:2008-07-21
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014315103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent