Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | OS014830 | PA |
NPI | 1003022245 |
---|---|
Provider Name | Traci L Cook |
First Address | Langhorne, PA 19047-1209 |
Second Address | Langhorne, PA 19047-1835 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2007 |
Last Update Date | 17/05/2021 |