Individual
NICOLE KOCKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
55 NESCONSET HWY, PORT JEFFERSON STATION, NY 11776-2631
(631) 474-8099
Mailing address
55 NESCONSET HWY STE 1, PORT JEFFERSON STATION, NY 11776-2631
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
403643
NY
Other
Enumeration date
08/20/2021
Last updated
09/29/2021
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