Healthcare Provider Details

I. General information

NPI: 1427200716
Provider Name (Legal Business Name): P. CHRISTOPHER COOK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2008
Last Update Date: 07/06/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 ELMWOOD AVE BOX 665
ROCHESTER NY
14642
US

IV. Provider business mailing address

601 ELMWOOD AVE BOX 665
ROCHESTER NY
14642
US

V. Phone/Fax

Practice location:
  • Phone: 585-275-8411
  • Fax: 585-276-1897
Mailing address:
  • Phone: 585-275-8411
  • Fax: 585-276-1897

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License Number14190
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License Number263838
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License Number263838
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: