Basic Information
| Provider Information | |||||||||
| NPI: | 1366894875 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | CRISTINA MOCCIA | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 80 WOODROW RD | ||||||||
| Address2: | |||||||||
| City: | STATEN ISLAND | ||||||||
| State: | NY | ||||||||
| PostalCode: | 103121313 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7183560008 | ||||||||
| FaxNumber: | 7183566566 | ||||||||
| Practice Location | |||||||||
| Address1: | 80 WOODROW RD | ||||||||
| Address2: | |||||||||
| City: | STATEN ISLAND | ||||||||
| State: | NY | ||||||||
| PostalCode: | 103121313 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7183560008 | ||||||||
| FaxNumber: | 7183566566 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/08/2016 | ||||||||
| LastUpdateDate: | 07/08/2016 | ||||||||
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| AuthorizedOfficialLastName: | MOCCIA | ||||||||
| AuthorizedOfficialFirstName: | CRISTINA | ||||||||
| AuthorizedOfficialMiddleName: | JOY | ||||||||
| AuthorizedOfficialTitleorPosition: | SPECIAL EDUCATION TEACHER | ||||||||
| AuthorizedOfficialTelephone: | 7183560008 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | M.S.SP.ED | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 1027524161 | NY | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
No ID Information.