Provider Demographics
NPI:1073316451
Name:CIOCCI, GRACE VICTORIA (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:GRACE
Middle Name:VICTORIA
Last Name:CIOCCI
Suffix:
Gender:
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 MEADOWBROOK AVE
Mailing Address - Street 2:
Mailing Address - City:WANAQUE
Mailing Address - State:NJ
Mailing Address - Zip Code:07465-1200
Mailing Address - Country:US
Mailing Address - Phone:201-937-9950
Mailing Address - Fax:
Practice Address - Street 1:227 LAKEVIEW AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011-4011
Practice Address - Country:US
Practice Address - Phone:862-238-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TA09167300224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant