Provider Demographics
NPI:1073359386
Name:ACOCA, GITTEL (RN, BSN)
Entity type:Individual
Prefix:
First Name:GITTEL
Middle Name:
Last Name:ACOCA
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 WESTMINSTER WAY
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970-4509
Mailing Address - Country:US
Mailing Address - Phone:845-300-6130
Mailing Address - Fax:
Practice Address - Street 1:295 PHILLIPS HILL RD
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-2018
Practice Address - Country:US
Practice Address - Phone:845-300-6130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-05
Last Update Date:2024-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY460921163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse