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General NPI Number Information
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NPI Number | 1104516269
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Entity Type | Organization
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Legal Business Name | COOPER PHYSICAL THERAPY PLLC
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Dates
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Enumeration Date | 05/11/2023
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Last Update Date | 05/11/2023
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Provider Practice Location Address
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Address Line | 122 W 26TH ST RM 701
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City | NEW YORK
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State | NY
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Zip | 10001-6804
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Country | US
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Telephone | 646-801-8565
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Fax |
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Provider Business Mailing Address
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Address Line | 1 WEST ST APT 2820
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City | NEW YORK
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State | NY
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Zip | 10004-1032
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Country | US
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Telephone | 909-709-8666
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JASON R COOPER
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Credential | DPT
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Telephone | 909-709-8666
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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