Provider Demographics
NPI:1043073927
Name:JEFFREY COOPER O.D., P.C.
Entity Type:Organization
Organization Name:JEFFREY COOPER O.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OD
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-236-4186
Mailing Address - Street 1:1448 86TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-3444
Mailing Address - Country:US
Mailing Address - Phone:718-265-2020
Mailing Address - Fax:718-837-0431
Practice Address - Street 1:1332 METROPOLITAN AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-7978
Practice Address - Country:US
Practice Address - Phone:718-829-5605
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-02
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty