Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 79976 | MA |
Y | 208200000X | Surgeon | 79976 | MA |
Y | 208600000X | Surgeon | 79976 | MA |
NPI | 1760417844 |
---|---|
Provider Name | Jeffrey T Cooper |
First Address | Boston, MA 02119 |
Second Address | Boston, MA 02118 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 21/09/2021 |