Provider Demographics
NPI:1154668267
Name:COTOGNO, LAUREN (MSED)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:COTOGNO
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 1:58 CROMWELL CIR
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-1102
Mailing Address - Country:US
Mailing Address - Phone:917-816-8302
Mailing Address - Fax:
Practice Address - Street 1:58 CROMWELL CIR
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304-1102
Practice Address - Country:US
Practice Address - Phone:917-816-8302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-09
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY906494467174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist