Provider Demographics
NPI:1982288502
Name:KOKONI, ROSALIE (MSED)
Entity Type:Individual
Prefix:
First Name:ROSALIE
Middle Name:
Last Name:KOKONI
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2565 E 14TH ST APT 3
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-3903
Mailing Address - Country:US
Mailing Address - Phone:347-458-3177
Mailing Address - Fax:
Practice Address - Street 1:2565 E 14TH ST APT 3
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-3903
Practice Address - Country:US
Practice Address - Phone:347-458-3177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-10
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2382037174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist