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General NPI Number Information
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NPI Number | 1821271354
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Entity Type | Organization
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Legal Business Name | JEFFREY COOPER O.D., P.C.
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Dates
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Enumeration Date | 12/06/2007
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Last Update Date | 12/07/2007
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Provider Practice Location Address
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Address Line | 539 PARK AVE
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City | NEW YORK
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State | NY
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Zip | 10065-8167
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Country | US
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Telephone | 212-758-0772
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Fax | 212-758-3532
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Provider Business Mailing Address
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Address Line | 539 PARK AVE
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City | NEW YORK
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State | NY
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Zip | 10065-8167
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Country | US
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Telephone | 212-758-0772
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Fax | 212-758-3532
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. JENNIFER COLAVITO
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Credential | O.D.
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Telephone | 212-758-0772
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | VUT006115
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License Number State | NY
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