Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152WC0802X | Optomitrist - Corneal and Contact Lenses | VUT003001 | NY |
NPI | 1295800050 |
---|---|
Provider Name | Dr. Jeffrey Cooper |
First Address | New York, NY 10065-8167 |
Second Address | Brooklyn, NY 11228-3429 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2006 |
Last Update Date | 05/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01557675 | (05) | NY |
P48939 | (02) | NY |