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General NPI Number Information
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NPI Number | 1124290069
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Entity Type | Organization
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Legal Business Name | TERENCE CARDINAL COOKE HEALTH CARE CENTER
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Dates
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Enumeration Date | 04/01/2008
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Last Update Date | 04/18/2008
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Provider Practice Location Address
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Address Line | 1249 5TH AVE
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City | NEW YORK
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State | NY
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Zip | 10029-4413
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Country | US
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Telephone | 212-360-3764
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Fax | 212-427-9488
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Provider Business Mailing Address
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Address Line | 1249 5TH AVE
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City | NEW YORK
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State | NY
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Zip | 10029-4413
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Country | US
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Telephone | 212-360-3764
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Fax | 212-427-9488
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Authorized Official
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Title or Position | SR VP - CFO
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Name | MRS. ANNMARIE C COVONE
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Credential |
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Telephone | 646-633-4702
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number | 7002345N
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License Number State | NY
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