Provider Demographics
NPI:1316257223
Name:KOCAK, JOCELYN JAYE (MS SLP)
Entity type:Individual
Prefix:MS
First Name:JOCELYN
Middle Name:JAYE
Last Name:KOCAK
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:462 OAK HILL RD
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13901-5402
Mailing Address - Country:US
Mailing Address - Phone:607-651-5511
Mailing Address - Fax:
Practice Address - Street 1:201 MAIN ST
Practice Address - Street 2:
Practice Address - City:VESTAL
Practice Address - State:NY
Practice Address - Zip Code:13850-1520
Practice Address - Country:US
Practice Address - Phone:607-757-2391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-13
Last Update Date:2010-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014384-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist