Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 031821 | NY |
NPI | 1093866683 |
---|---|
Provider Name | Dr. Louis M Cooper |
First Address | Rye, NY 10580-1949 |
Second Address | Rye Brook, NY 10573-2867 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2007 |
Last Update Date | 25/03/2011 |