Healthcare Provider Details
I. General information
NPI: 1437226644
Provider Name (Legal Business Name): PATRICIA JOAN COOPER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5645 MAIN ST NY HOSPITAL MEDICAL CENTER OF QUEENS
FLUSHING NY
11355-5045
US
IV. Provider business mailing address
5645 MAIN ST NY HOSPITAL MEDICAL CENTER OF QUEENS
FLUSHING NY
11355-5045
US
V. Phone/Fax
- Phone: 718-670-1426
- Fax: 610-617-6280
- Phone: 718-670-1426
- Fax: 610-617-6280
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | F381254 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: