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General NPI Number Information
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NPI Number | 1750377479
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Entity Type | Individual
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Provider Name | KATHRYN COOPER NP
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Gender | Female
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Dates
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Enumeration Date | 09/27/2005
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Last Update Date | 08/14/2024
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Provider Practice Location Address
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Address Line | 739 IRVING AVE STE 500
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City | SYRACUSE
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State | NY
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Zip | 13210-1664
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Country | US
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Telephone | 315-470-7409
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 W FAYETTE ST STE 400
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City | SYRACUSE
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State | NY
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Zip | 13204-2866
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Country | US
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Telephone | 315-937-3433
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | F331842
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | F331842
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License Number State | NY
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