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NPI Code Detail

MEDICARE: ELIZABETH ELLEN COOLEY MD

MEDICARE:   ELIZABETH ELLEN COOLEY  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician9446NH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700862570
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH ELLEN COOLEY MD
Provider Business Mailing Address
First Line : PO BOX 117
Second Line :
City : RINDGE
State : NH
Zip : 03461-0117
Country : US
Telephone Number : 603-899-9563
Fax Number : 603-899-9567
Provider Business Practice Location Address
First Line : 145 US ROUTE 202
Second Line : RINDGE FAMILY PRACTICE
City : RINDGE
State : NH
Zip : 03461-7104
Country : US
Telephone Number : 603-899-9563
Fax Number : 603-899-9567
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2005
Last Update Date : 11/09/2015

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Directions to “ ELIZABETH ELLEN COOLEY MD” Practice Location

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