MEDICARE: ERIKA COOPER NP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	406682-01	NY
2	363LA2200X	Adult Health Nurse Practitioner	F307826-1	NY

General Provider Information

NPI Number	:	1508219106
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIKA COOPER NP

Provider Business Mailing Address
First Line	:	322 W 52ND ST # 1884
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10019-6262
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	15 W 136TH ST
Second Line	:	2ND FLOOR, KOUNTZ PAVILION
City	:	NEW YORK
State	:	NY
Zip	:	10037-2104
Country	:	US
Telephone Number	:	212-939-8078
Fax Number	:

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

Provider Enumeration Date	:	07/19/2016
Last Update Date	:	05/11/2026

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