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General NPI Number Information
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NPI Number | 1275674855
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Entity Type | Individual
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Provider Name | LYNNDEY C COOK RPA
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Gender | Male
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3003 NEW HYDE PARK RD SUITE 410
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City | NEW HYDE PARK
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State | NY
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Zip | 11042-1214
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Country | US
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Telephone | 516-354-8346
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Fax | 516-437-2396
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Provider Business Mailing Address
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Address Line | 172 ALEXANDER AVE
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City | NESCONSET
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State | NY
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Zip | 11767-1602
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Country | US
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Telephone | 631-366-3833
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 000427-1
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License Number State | NY
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