Provider Demographics
NPI:1295929867
Name:DR RAMIN B COCOZIELLO MD PC
Entity type:Organization
Organization Name:DR RAMIN B COCOZIELLO MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMIN
Authorized Official - Middle Name:BARRY
Authorized Official - Last Name:COCOZIELLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-794-0910
Mailing Address - Street 1:12-15 BROADWAY
Mailing Address - Street 2:SUITE E
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-2031
Mailing Address - Country:US
Mailing Address - Phone:201-794-0910
Mailing Address - Fax:201-794-2164
Practice Address - Street 1:12-15 BROADWAY
Practice Address - Street 2:SUITE E
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-2031
Practice Address - Country:US
Practice Address - Phone:201-794-0910
Practice Address - Fax:201-794-2164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-28
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06185100174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ12603OtherUHP
NJ2834209000OtherAMERIHEALTH
NJ3057336007OtherCIGNA
NJ6564101Medicaid
NJ1478475OtherAETNA
NJ0141417OtherGHI
NJ1042204OtherHORIZON NJ HEALTH
NJP394261OtherOXFORD HEALTH PLANS
NJ01000035500OtherAMERICHOICE
NJ3K4802OtherHEALTHNET
NJ14138OtherAMERIGROUP
NJP394261OtherOXFORD HEALTH PLANS
NJ14138OtherAMERIGROUP
NJ3057336007OtherCIGNA
NJ=========OtherBLUE SHIELD
NJ=========OtherCHN
NJ0141417OtherGHI
NJ1478475OtherAETNA