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General NPI Number Information
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NPI Number | 1104123157
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Entity Type | Individual
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Provider Name | KARLA COOPER PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 02/25/2011
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Last Update Date | 12/03/2019
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Provider Practice Location Address
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Address Line | 8210 37TH AVE
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-7023
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Country | US
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Telephone | 718-205-5001
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Fax | 718-205-5644
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Provider Business Mailing Address
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Address Line | 115 SAYRE PL
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City | VALLEY STREAM
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State | NY
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Zip | 11580-5011
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Country | US
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Telephone | 917-575-8063
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 055435
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License Number State | NY
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