Provider Demographics
NPI:1932438462
Name:COCCO, KAREN M (PHD)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:M
Last Name:COCCO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 STONE HILL RD
Mailing Address - Street 2:APT. L4
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081-2115
Mailing Address - Country:US
Mailing Address - Phone:862-216-4202
Mailing Address - Fax:
Practice Address - Street 1:57 UNION PL
Practice Address - Street 2:SUITE 212
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-2568
Practice Address - Country:US
Practice Address - Phone:862-216-4202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-11
Last Update Date:2014-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00483400103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist