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General NPI Number Information
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NPI Number | 1275775595
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Entity Type | Organization
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Legal Business Name | CHOICE GYNECOLOGICAL SERVICES, PC
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Dates
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Enumeration Date | 04/01/2009
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Last Update Date | 04/02/2009
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Provider Practice Location Address
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Address Line | 8926 ROOSEVELT AVE 2ND FLOOR
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-7857
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Country | US
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Telephone | 718-205-3400
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Fax | 718-205-6100
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Provider Business Mailing Address
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Address Line | 8926 ROOSEVELT AVE 2ND FLOOR
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-7857
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Country | US
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Telephone | 718-205-3400
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Fax | 718-205-6100
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. JOEL COOPER
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Credential | M.D.
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Telephone | 718-205-3400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 092267
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License Number State | NY
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