Basic Information
| Provider Information | |||||||||
| NPI: | 1124130802 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COCCARO-SANTOS | ||||||||
| FirstName: | JILL | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3333 HENRY HUDSON PKWY | ||||||||
| Address2: | APARTMENT 20R | ||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104633224 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6463065544 | ||||||||
| FaxNumber: | 3479474579 | ||||||||
| Practice Location | |||||||||
| Address1: | 1978 CROMPOND ROAD | ||||||||
| Address2: | MOUNT KISCO MEDICAL GROUP PC | ||||||||
| City: | CORTLANDT MANOR | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10567 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9147392121 | ||||||||
| FaxNumber: | 9147392185 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2006 | ||||||||
| LastUpdateDate: | 12/10/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 030070 | NY | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 363LF0000X | F338865-1 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.