Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | F000903-1 | NY |
NPI | 1023166162 |
---|---|
Provider Name | Dale Marie Cook |
First Address | Kings Park, NY 11754-1521 |
Second Address | Greenlawn, NY 11740-1710 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2007 |
Last Update Date | 08/07/2007 |