Provider Demographics
NPI:1124743166
Name:CUOCO, ASHLEY ROSE (NP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ROSE
Last Name:CUOCO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1460 VICTORY BLVD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301-3914
Mailing Address - Country:US
Mailing Address - Phone:718-442-8351
Mailing Address - Fax:718-442-4073
Practice Address - Street 1:1460 VICTORY BLVD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301-3914
Practice Address - Country:US
Practice Address - Phone:718-442-8351
Practice Address - Fax:718-442-4073
Is Sole Proprietor?:No
Enumeration Date:2022-10-11
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY349410363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily