Healthcare Provider Details

I. General information

NPI: 1780071902
Provider Name (Legal Business Name): DANIEL COOK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2015
Last Update Date: 05/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 E 68TH ST ROOM P-03-319, BOX 124
NEW YORK NY
10065-4870
US

IV. Provider business mailing address

575 LEXINGTON AVE
NEW YORK NY
10022-6102
US

V. Phone/Fax

Practice location:
  • Phone: 212-746-2941
  • Fax:
Mailing address:
  • Phone: 212-590-5750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number298588
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: