Provider Demographics
NPI:1003022245
Name:COOK, TRACI L (DO)
Entity Type:Individual
Prefix:
First Name:TRACI
Middle Name:L
Last Name:COOK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1203 LANGHORNE NEWTOWN RD
Mailing Address - Street 2:#225, ST CLARE BDG
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1209
Mailing Address - Country:US
Mailing Address - Phone:215-750-7771
Mailing Address - Fax:215-750-6935
Practice Address - Street 1:540 WOODBOURNE RD
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1835
Practice Address - Country:US
Practice Address - Phone:215-750-7771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS014830207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics