MEDICARE: DR. JEFFREY COOPER OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152WC0802X	Corneal and Contact Management Optometrist	VUT003001	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295800050
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY COOPER OD

Provider Business Mailing Address
First Line	:	539 PARK AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10065-8167
Country	:	US
Telephone Number	:	212-758-0772
Fax Number	:

Provider Business Practice Location Address
First Line	:	1448 86TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11228-3429
Country	:	US
Telephone Number	:	718-236-4186
Fax Number	:	718-837-0341

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	11/05/2015

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Directions to “ DR. JEFFREY COOPER OD” Practice Location

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