Provider Demographics
NPI:1831934546
Name:COCCHIARELLA, DANIEL ANTHONY
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:ANTHONY
Last Name:COCCHIARELLA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 MARYS DR
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-4213
Mailing Address - Country:US
Mailing Address - Phone:848-298-9552
Mailing Address - Fax:
Practice Address - Street 1:711 MARYS DR
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-4213
Practice Address - Country:US
Practice Address - Phone:848-298-9552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities