Provider Demographics
NPI:1275674855
Name:COOK, LYNNDEY C (RPA)
Entity Type:Individual
Prefix:
First Name:LYNNDEY
Middle Name:C
Last Name:COOK
Suffix:
Gender:M
Credentials:RPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 ALEXANDER AVE
Mailing Address - Street 2:
Mailing Address - City:NESCONSET
Mailing Address - State:NY
Mailing Address - Zip Code:11767-1602
Mailing Address - Country:US
Mailing Address - Phone:631-366-3833
Mailing Address - Fax:
Practice Address - Street 1:3003 NEW HYDE PARK RD
Practice Address - Street 2:SUITE 410
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1214
Practice Address - Country:US
Practice Address - Phone:516-354-8346
Practice Address - Fax:516-437-2396
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000427-1363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical