MEDICARE: MS. FRAN E COOK-BOLDEN 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
1	207N00000X	Dermatology Physician	181672	NY

General Provider Information

NPI Number	:	1710990346
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. FRAN E COOK-BOLDEN MD

Provider Business Mailing Address
First Line	:	150 E 58TH ST
Second Line	:	3RD FLOOR ANNEX
City	:	NEW YORK
State	:	NY
Zip	:	10155-0002
Country	:	US
Telephone Number	:	212-223-6599
Fax Number	:	212-223-6598

Provider Business Practice Location Address
First Line	:	150 E 58TH ST
Second Line	:	3RD FLOOR ANNEX
City	:	NEW YORK
State	:	NY
Zip	:	10155-0002
Country	:	US
Telephone Number	:	212-223-6599
Fax Number	:	212-223-6598

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/14/2006
Last Update Date	:	04/07/2009

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