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General NPI Number Information
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NPI Number | 1912299751
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Entity Type | Individual
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Provider Name | ELEANOR COOPER
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Gender | Female
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Dates
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Enumeration Date | 05/12/2011
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Last Update Date | 05/12/2011
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Provider Practice Location Address
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Address Line | 117 W 65TH AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19120-1026
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Country | US
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Telephone | 267-974-6256
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Fax |
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Provider Business Mailing Address
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Address Line | 108 MARGARETTA DR
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City | MIDDLETOWN
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State | DE
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Zip | 19709-9821
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Country | US
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Telephone | 267-205-6763
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | PN282236
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License Number State | PA
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