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General NPI Number Information
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NPI Number | 1396783627
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Entity Type | Individual
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Provider Name | ROBERT B COOPER M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/02/2006
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Last Update Date | 11/10/2020
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Provider Practice Location Address
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Address Line | 635 MADISON AVE 17TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10022-1009
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Country | US
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Telephone | 212-717-4967
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Fax | 212-717-4970
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Provider Business Mailing Address
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Address Line | 235 E 67TH ST RM 203
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City | NEW YORK
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State | NY
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Zip | 10065-6040
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Country | US
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Telephone | 212-717-4967
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Fax | 212-717-4970
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 150663
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License Number State | NY
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