Individual
DR. SUSAN PAKRAVAN COCOZIELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1 BROADWAY, SUITE 105, ELMWOOD PARK, NJ 07407-1842
(201) 773-6777
(201) 300-6880
Mailing address
1 BROADWAY, STE 105, ELMWOOD PARK, NJ 07407-1843
(201) 794-7717
(201) 794-7717
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1915908
—
NJ
Enumeration date
11/20/2006
Last updated
09/06/2019
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