Provider Demographics
NPI:1255783288
Name:SCOCCA, DONNA
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:SCOCCA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 PARTRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-4703
Mailing Address - Country:US
Mailing Address - Phone:631-543-1554
Mailing Address - Fax:
Practice Address - Street 1:7 PARTRIDGE DR
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-4703
Practice Address - Country:US
Practice Address - Phone:631-543-1554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-01
Last Update Date:2016-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst