Doctor Name: | RENEE COOKE |
NPI Number: | 1316281579 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ANP |
License Number: | 306241 |
Business Practice Address: | 366 N Broadway Jericho, NY - 117532025 |
Business Phone Number: | 5169357272 |
Business Fax Number: | |
Mailing Address: | 129 Jerusalem Ave, HEMPSTEAD |
State: | NY |
Postal Code: | 115506045 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 11/11/2012 |
NPI Last Update Date: | 11/11/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | 306241 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |