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NPI Code Detail

MEDICARE: LUCY M COOK LMT

MEDICARE: LUCY M COOK LMT
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
1225700000XMassage Therapist032866NY

General Provider Information

NPI Number : 1770347130
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUCY M COOK LMT
Provider Business Mailing Address
First Line : 398 MCDONALD AVE APT 2R
Second Line :
City : BROOKLYN
State : NY
Zip : 11218-2212
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 398 MCDONALD AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11218-2212
Country : US
Telephone Number : 678-718-8116
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2024
Last Update Date : 02/07/2024

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